盐酸艾司氯胺酮在剖宫产全身麻醉诱导中的应用研究

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[Abstract] Objective：To observe the application effect of Esketamine Hydrochloride in the induction of general anesthesia for cesarean section.Method：A total of 8O parturients who underwent general anesthesia cesarean sectionatFuzhou Hospital from June 2023 to September 2O24 were selected as the research subjects.According to the rom number table method，they were divided into two groups，with 4O cases ineach group.Patients inducedby Esketamine Hydrochloride anesthesia wereclassifiedas theobservation group， those induced by Sufentanil anesthesia were classified as the control group.The mean arterial pressure heartrateofthetwo groupsbefore induction，5minutesafterinduction，during tracheal intubation，at skin incision， at awakening were analyzed.The Ramsay sedation score VAS score were used to evaluate the sedationanalgesic effects， the Apgar scores ofnewborns in each group at1，5，1O min after birth were recorded.Result：Before induction，there wereno statisticallysignificant differences inheartrate meanarterial pressure between the two groups （ P >0.05）.During tracheal intubation skin incision， the heart rate mean arterialpressre inboth groups werelowerthanthosebefore induction，butthose intheobservation group were higher than those in the control group （ P <0.05）.At awakening，there were no statistically significant differencesin heart rate mean arterial pressure between the two groups （ P >0.05）. The Ramsay sedation score during the recovery period the VAS score 6 hours after recovery in the observation group were lower than those of the control group （ P <0.05）. There were no statistically significant differences in the Apgar scores of the two groups of newborns at1 5 min after birth （ P> 0.05）; the Apgar score of the newborns in the observation group at 1O minutes after birth was higher than that in the control group （P<0.05 ）.Conclusion：Esketamine Hydrochloride can playasignificant rolein the induction of general anesthesia for cesarean section.Compared with Sufentanil anesthesia，itcan better maintain the hemodynamic stabilityof parturients，improve their analgesic sedative efects，has no significant mpact on the Apgar score of newborns.

[Keywords]Esketamine HydrochlorideSufentanilCesarean section Induction of general anesthesia Analgesia sedation

First-author'saddress：Anesthesia Department，Fuzhou MaternalHospital，Fuzhou 344000， China

doi：10.3969/j.issn.1674-4985.2025.32.031

剖宫产麻醉一直以来都是产科领域关注的热点之一，临床多采用椎管内麻醉达到镇痛镇静的目的，这对于大多数产妇而言是安全有效的[，但依然有部分产妇对椎管内麻醉有一定的禁忌证，如血液系统疾病、腰椎畸形、穿刺部位感染、精神疾病、急产、前置胎盘出血、先兆子宫破裂等情况，需要考虑进行全身麻醉[2，但临床上现有的全身麻醉药物可能对产妇呼吸系统、循环系统、消化系统、内分泌系统等产生不同程度的负面影响，而且大多数剖宫产插管全麻是在紧急状态下进行，若前期气道准备工作做得不够充分，还容易出现气道不良事件，例如返流室息，给围手术期麻醉管理带来巨大挑战，不仅如此，药物的循环还会通过胎盘屏障进入胎儿，加大胎儿缺血缺氧风险，影响胎儿健康，特别是可能对胎儿智力与发育有影响[3]。（剩余5611字）