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腹腔镜胆囊切除术后地佐辛和艾司氯胺酮分别复合舒芬太尼镇痛效果的比较：一项前瞻性随机对照研究
贵州医科大学 麻醉与心脏电生理课题组
翻译：宋雨婷 编辑：杨荣峰 审校：曹莹
舒芬太尼与地佐辛或艾司氯胺酮的复合使用常见于术后镇痛。然而，其疗效缺乏临床证据。本研究旨在比较艾司氯胺酮或地佐辛复合舒芬太尼缓解腹腔镜胆囊切除术（LC）后的镇痛效果。
本研究共纳入58例患者，且随机分为艾司氯胺酮组（ES组）和地佐辛组（DE组）。在ES组中，使用1.5 mg/kg艾司氯胺酮。DE组使用0.3mg/kg地佐辛。主要结局指标为术后4 h、8 h、24 h和48 h的视觉模拟量表（VAS）评分。次要结局指标是麻醉诱导前10分钟、术后24 h和术后48 h血清中的白细胞介素6（IL-6）和C反应蛋白（CRP）水平。
ES组与DE组术后4 h、8 h、24 h和48 h的VAS评分分别为2.70与3.50（P=0.013）、2.35与3.15（P=0.004）、1.69与2.58（P=0.002）和1.50与2.26（P=0.002）。ES组和DE组麻醉诱导10 min、术后24 h和术后48 h血清IL-6浓度分别为34.39与34.12（P=0.901）、112.33与129.60（P=0.014）和89.69与108.46（P<0.001）。ES组和DE组麻醉诱导前10 min、术后24 h和术后48 h血清CRP水平分别为5.99与5.86（P=0.639）、28.80与35.37（P<0.001）和23.17与30.11（P< 0.001）。
对于LC术后疼痛，1.5mg/kg艾司氯胺酮比0.3mg/kg地佐辛可提供更好的镇痛并降低炎症反应。
原始文献来源：Deng B, Wang D, Xie Z, et al. Comparison of the analgesic effect of dezocine and esketamine in combination with sufentanil respectively after laparoscopic cholecystectomy: a prospective randomized controlled study. BMC Anesthesiol. 2024;24(1):51. Published 2024 Feb 5.
Comparison of the analgesic effect of dezocine and esketamine in combination with sufentanil respectively after laparoscopic cholecystectomy: a prospective randomized controlled study
Background: Sufentanil in combination with dezocine or esketamine is often used for postoperative analgesia. However, there is a lack of clinical evidence of efficacy. This study compares the analgesic effects of esketamine and dezocine combined with sufentanil for relieving pain after laparoscopic cholecystectomy(LC).
Methods: A total of 58 patients were randomly assigned to the esketamine group (ES group) and dezocine group (DE group). In the ES group, 1.5 mg/kg esketamine was used. In the DE group, 0.3 mg/kg dezocine was used. Primary outcome measures were Visual Analog Scale (VAS) score at 4 h, 8 h, 24 h and 48 h after surgery. The second outcome measures were Interleukin-6 (IL-6) and C-reactive protein (CRP) levels in the serum 10 minutes before anesthesia induction, and at 24 h and 48 h after surgery.
Results: The VAS scores at 4 h, 8 h, 24 h and 48 h after the surgery in the ES group vs DE group were 2.70 vs 3.50(P=0.013),2.35 vs 3.15(P=0.004),1.69 vs 2.58(P=0.002), and 1.50 vs 2.26(P=0.002), respectively. The serum IL-6 concentrations 10 minutes before anesthesia induction, and at 24 h and 48 h after surgery in the ES group and DE group were 34.39 and 34.12(P=0.901),112.33 and 129.60(P=0.014), and 89.69 and 108.46(P<0.001), respectively. The CRP levels in serum 10 minutes before anesthesia induction, and at 24 h and 48 h after the surgery in the ES group and DE group were 5.99 and 5.86(P=0.639), 28.80 and 35.37(P<0.001), and 23.17 and 30.11(P<0.001), respectively.
Conclusion: For postoperative pain after LC, 1.5mg/kg esketamine provided better analgesia and reduced inflammation levels than 0.3mg/kg dezocine.
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