Effects of esketamine on respiratory depression after radical thoracoscopic resection of lung cancer in elderly patients

doi:10.11958/20230281

Abstract

Abstract:

Objective To investigate the effect of esketamine on respiratory depression after radical thoracoscopic resection of lung cancer in elderly patients. Methods Sixty elderly patients undergoing radical operation of lung cancer under general anesthesia were selected and divided into the observation group (30 cases) and the control group (30 cases) according to random number table method. Patient-controlled intravenous analgesia was performed after surgery. The analgesic formula in the observation group was esketamine 0.2 mg/kg+Sufentanil 1.3 μg/kg+dexamethasone 5 mg+dexmedetomidine 100 μg, and the analgesic formula of the control group was Sufentanil 1.5 μg/kg+ dexamethasone 5 mg+ dexmedetomidine 100 μg. Visual analog scale (VAS) at rest and during exercise and Ramsay sedation score were recorded at 4, 8, 24 and 48 h after surgery. The Montreal Cognitive Assessment Scale (MoCA) was used to assess cognitive function 1 day before surgery and 1 and 3 days after surgery. The duration of operation, length of hospital stay, rate of remedial analgesia and postoperative complications were recorded. Results The hospitalization time of the observation group was shorter than that of the control group (P<0.05). There was no significant difference in resting VAS score within 48 h after surgery between the two groups. The VAS scores at 4, 8, 24 and 48 h after operation were significantly lower in the observation group than those of the control group (P<0.05). Ramsay scores within 48 h after surgery were higher in the observation group than those in the control group (P<0.05). There were no significant differences in MoCA scores between the two groups. Incidence rates of analgesia, hypotension, dizziness and respiratory depression were lower in the observation group than those in the control group (P<0.05), and there were no significant differences in incidences of nausea and vomiting between the two groups. Conclusion Esketamine can provide better analgesia and sedation after thoracoscopic lung cancer surgery in elderly patients, reduce hospital stay, and reduce the incidence of postoperative respiratory depression, hypotension and dizziness.

Key words: lung neoplasms, thoracoscopes, esketamine, elderly patients, respiratory depression

CLC Number:

R614

Figures/Tables 5

References 21

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组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	ASA分级（Ⅱ/Ⅲ）	手术时间/min	住院时间/d	合并症
组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	ASA分级（Ⅱ/Ⅲ）	手术时间/min	住院时间/d	高血压	糖尿病
对照组	30	18/12	66.57±5.74	23.13±2.63	9/21	112.00±47.95	9.93±3.24	10	2
观察组	30	20/10	67.23±7.99	23.27±2.45	8/22	116.33±46.80	8.47±1.68	10	3
t或χ²		0.287	0.371	0.212	0.082	0.354	2.204^＊	0.000	0.218

组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	ASA分级（Ⅱ/Ⅲ）	手术时间/min	住院时间/d	合并症
组别	n	性别（男/女）	年龄/岁	BMI/（kg/m²）	ASA分级（Ⅱ/Ⅲ）	手术时间/min	住院时间/d	高血压	糖尿病
对照组	30	18/12	66.57±5.74	23.13±2.63	9/21	112.00±47.95	9.93±3.24	10	2
观察组	30	20/10	67.23±7.99	23.27±2.45	8/22	116.33±46.80	8.47±1.68	10	3
t或χ²		0.287	0.371	0.212	0.082	0.354	2.204^＊	0.000	0.218

组别	n	静息
组别	n	4 h	8 h	24 h	48 h
对照组	30	2.13±0.82	2.67±0.48	1.90±0.85	1.13±0.82
观察组	30	2.10±0.85	2.60±0.50	1.87±0.82	0.77±0.43
组别	n	运动
组别	n	4 h	8 h	24 h	48 h
对照组	30	4.13±0.82	6.23±0.86	5.20±0.85	4.17±0.91
观察组	30	3.43±0.63	5.13±0.82	4.07±0.87	3.47±0.73
t		3.718^＊＊	5.077^＊＊	5.118^＊＊	3.280^＊＊

组别	n	静息
组别	n	4 h	8 h	24 h	48 h
对照组	30	2.13±0.82	2.67±0.48	1.90±0.85	1.13±0.82
观察组	30	2.10±0.85	2.60±0.50	1.87±0.82	0.77±0.43
组别	n	运动
组别	n	4 h	8 h	24 h	48 h
对照组	30	4.13±0.82	6.23±0.86	5.20±0.85	4.17±0.91
观察组	30	3.43±0.63	5.13±0.82	4.07±0.87	3.47±0.73
t		3.718^＊＊	5.077^＊＊	5.118^＊＊	3.280^＊＊

组别	n	术后4 h	术后8 h	术后24 h	术后48 h
对照组	30	1.53±0.51	1.60±0.50	1.77±0.43	1.93±0.25
观察组	30	1.83±0.38	1.87±0.35	1.97±0.18	1.97±0.18