艾司氯胺酮在围术期不同场景的临床应用进展

打开文本图片集

中图分类号：R614 文献标志码：A 文章编号：2097-7174（2026）03-0269-07

DOI：10.3969/j.issn. 2097-7174.2026.03.012

Clinical application progress of esketamine application in differentperioperativescenarios

WANG Jiasheng'，HU Qian’，CAO Ruiyang1，LIUWenkai’，WANG Lifeng2，3，4 （1.The First Clinical Medical School of Gannan Medical University；2.Anesthesia Surgery Center， The First AffiliatedHospital of Gannan Medical University；3.Institute of Pain Medicine， Gannan Medical University；4.Ganzhou Key Laboratoryof Anesthesiology，Ganzhou，Jiangxi ）

Abstract：Esketamine is theS-enantiomerof ketamine.AsapotentN-methyl-D-aspartate（NMDA）receptorantagonist withhigh afinity，itexhibitssedative，analgesic，andantidepressant properties，etc.Thepotencyof esketamineis approximately twicethatofracemicketamine，along with several notable advantages：arapidonsetofaction，mildrespiratory depression，andreduced psychiatric adverse efects.In recent years，the perioperativeapplication of esketamine has garnered increasing atention.It has shown promising clinical prospects，particularly inobstetric anesthesia，pediatric surgicalanesthesia，orthopedicsurgical anesthesia，painless diagnosticand therapeuticprocedures，andspecialclinical scenarios.This paper summarizes the pharmacological properties，mechanism of action，and current clinicalapplications of esketamineinvariousclinicalscenarios，withthegoalofoferingevidence tosupportitsrationalapplicationinclinical practice.

KeyWords：Esketamine；Perioperative application；Sedation；Analgesia；Antidepressant

艾司氯胺酮是由消旋氯胺酮衍生而来的一种立体异构体，与氯胺酮相似，是一种静脉麻醉药，具有独特的麻醉、镇痛和抗抑郁特性。（剩余18611字）