Effects of intraoperative intravenous esketamine infusion on the quality of recovery and pain after laparoscopic cholecystectomy

医学 麻醉 丸(消化) 瑞芬太尼 异丙酚 可视模拟标度 胆囊切除术 生理盐水 不利影响 腹部外科 外科 内科学
作者
Lifang Li,Zhangqin Cheng,Liuyi Wang,Yuhan Zhang,Yu Qi,Meiyan Zhou,Liwei Wang
出处
期刊:Research Square - Research Square
标识
DOI:10.21203/rs.3.rs-2484571/v1
摘要

Abstract Background: Laparoscopic cholecystectomy (LC) is the most common intra-abdominal surgical procedure globally, which frequently leads to substantial postoperative pain. Opioids play a major role in pain management previously. Some studies found that esketamine could reduce pain and opioid consumption. However, the relationship between esketamine and the postoperative quality of recovery and pain is uncertain undergoing LC. Thestudy aimed to evaluate the effects of intraoperative intravenous esketamine infusion on the quality of recovery (QoR) and pain after laparoscopic cholecystectomy (LC). Patients and methods: A total of 152 patients were randomly divided into the control (0.9% saline), 0.2 mg (esketamine bolus 0.2 mg/kg, followed by 0.2 mg/kg/h) and 0.3 mg (esketamine bolus 0.3 mg/kg, followed by 0.3 mg/kg/h) groups. A bolus of 0.9% saline/esketamine was administered before endotracheal intubation, followed by continuous infusion until gallbladder removal. The primary outcomes were 40-item QoR (QoR-40) score on postoperative day 1 (POD-1) and pain (Numerical Rating Scale, NRS) score during rest and coughing at different time points. The secondary outcomes were hemodynamic parameters, propofol and remifentanil consumption, 48-h cumulative consumption of flurbiprofen axetil and tropisetron hydrochloride, postoperative parameters, and adverse events. Results: The global QoR-40 score on POD-1 was lower in the control group than in the 0.2 and 0.3 mg groups. The NRS score during rest and coughing was lower in the 0.2 and 0.3 mg groups than in the control group at alltime points. Hemodynamic parameters were more stable in the esketamine groups. Propofol and remifentanil consumption was higher in the control group than in the esketamine groups. The 48-h cumulative consumption of flurbiprofen axetil and tropisetron hydrochloride was lower in the esketamine groups. The extubation time was longer in the 0.3 mg group than in the control and 0.2 mg groups. The control group had more patients with oxygen saturation (SpO2) <95%. The incidence of postoperative vertigo, nystagmus and diplopia was higher in the 0.3 mg group than in the control and 0.2mg groups. Conclusions: Intravenous esketamine infusion improved the QoR on POD-1 after LC. It provided a good analgesic effect, reduced the 48-h cumulative consumption of flurbiprofen axetil and tropisetron hydrochloride, and resulted in stable hemodynamic parameters. However, a higher esketamine dose prolonged the extubation time and increased the incidence of adverse events. Trial registration: This study was approved by the Ethics Committee of Xuzhou Central Hospital (XZXY-LK-20211209-051) and registered at ClinicalTrials.gov (19/12/2021, ChiCTR2100054508). This randomized triple-blind placebo-controlled trial was performed from December 2021 to August 2022. Written informed consent was obtained from all patients. The study was terminated after follow-up completion of the last study participant.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
聪明小丸子完成签到,获得积分10
刚刚
怡然诗珊发布了新的文献求助20
1秒前
暗号完成签到 ,获得积分10
1秒前
不爱吃鱼的猫完成签到,获得积分10
1秒前
凌代萱完成签到 ,获得积分10
3秒前
霍凡白完成签到,获得积分10
7秒前
妮妮完成签到,获得积分10
10秒前
chen完成签到,获得积分10
11秒前
清秀的之桃完成签到 ,获得积分10
13秒前
13秒前
阿耒发布了新的文献求助10
17秒前
阿尔法贝塔完成签到 ,获得积分10
21秒前
楚寅完成签到 ,获得积分10
21秒前
万能图书馆应助阿耒采纳,获得10
24秒前
qizhia完成签到 ,获得积分10
25秒前
S飞完成签到 ,获得积分10
26秒前
John完成签到 ,获得积分10
28秒前
30秒前
动听帆布鞋完成签到,获得积分10
31秒前
怡然诗珊完成签到,获得积分10
33秒前
南波兔发布了新的文献求助10
34秒前
飞鱼z完成签到 ,获得积分10
35秒前
zyb完成签到 ,获得积分10
37秒前
刚子完成签到 ,获得积分10
40秒前
小墨墨完成签到 ,获得积分10
47秒前
看文献完成签到,获得积分10
47秒前
南波兔完成签到,获得积分20
48秒前
好好学习完成签到 ,获得积分10
48秒前
十三完成签到 ,获得积分10
49秒前
kevinjiang完成签到,获得积分10
49秒前
mumuyayaguoguo完成签到 ,获得积分10
49秒前
史小刀完成签到 ,获得积分10
56秒前
huangyi完成签到 ,获得积分10
57秒前
乌云乌云快走开完成签到,获得积分10
58秒前
苏震坤发布了新的文献求助10
58秒前
苏菲完成签到 ,获得积分10
1分钟前
心有猛虎完成签到,获得积分10
1分钟前
高高的天亦完成签到 ,获得积分10
1分钟前
natsu401完成签到 ,获得积分10
1分钟前
CodeCraft应助可靠绮琴采纳,获得10
1分钟前
高分求助中
Solution Manual for Strategic Compensation A Human Resource Management Approach 1200
Natural History of Mantodea 螳螂的自然史 1000
Glucuronolactone Market Outlook Report: Industry Size, Competition, Trends and Growth Opportunities by Region, YoY Forecasts from 2024 to 2031 800
A Photographic Guide to Mantis of China 常见螳螂野外识别手册 800
Autoregulatory progressive resistance exercise: linear versus a velocity-based flexible model 500
The analysis and solution of partial differential equations 400
Spatial Political Economy: Uneven Development and the Production of Nature in Chile 400
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 细胞生物学 免疫学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3335469
求助须知:如何正确求助?哪些是违规求助? 2964524
关于积分的说明 8614307
捐赠科研通 2643432
什么是DOI,文献DOI怎么找? 1447485
科研通“疑难数据库(出版商)”最低求助积分说明 670664
邀请新用户注册赠送积分活动 659032