纳洛酮用于接受氯胺酮辅助麻醉的抑郁症患者的复苏和抗抑郁作用的影响
Effects of naloxone on resuscitation and antidepressant effects in patients with depression undergoing ketamine-assisted anesthesia
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| DOI |
| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2020, 47(2) |
| 作者 |
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| 作者单位 |
安阳市中医院麻醉科 ;
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| 摘要 |
目的：探讨纳洛酮用于接受氯胺酮辅助麻醉的抑郁症患者的复苏和抗抑郁作用的影响。方法：选取2017年2月至2019年2月于本院行腹腔镜手术合并抑郁症患者86例为研究对象，按随机数字表法分为两组，各43例。所有患者均采用小剂量氯胺酮-瑞芬太尼进行麻醉，其中一组给予纳洛酮用于术后催醒（纳洛酮组），另一组则给予生理盐水（对照组）。比较两组各时间点痛阈值和HAMD-17评分、拔管时间、自主呼吸恢复时间和睁眼时间。结果：纳洛酮组术后1h、2h的痛阈值均明显高于对照组（P<0.05）；术后，两组HAMD-17评分较术前均有所降低，其中纳洛酮组术后1d和3d的HAMD-17评分均明显高于对照组（P<0.05）；纳洛酮组拔管时间、自主呼吸恢复时间和睁眼时间均明显短于对照组（P<0.05）。结论：纳洛酮可拮抗瑞芬太尼麻醉所致的痛觉敏化，且有助于患者术后复苏，但会显著减轻氯胺酮的抗抑郁作用，氯胺酮在治疗抑郁症患者所产生的急性抗抑郁作用可能需要阿片系统激活。
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| Abstract |
OBJECTIVE: To investigate the effects of naloxone on the recovery and antidepressant effects of patients with depression who received ketamine-assisted anesthesia. METHODS: 86 patients with laparoscopic surgery and depression in our hospital from February 2017 to February 2019 were selected as study subjects,and were divided into two groups according to the random number table method,with 43 cases in each group.All patients were anesthetized with a small dose of ketamine-remifentanil,one group was given naloxone for postoperative wake-up (naloxone group), and the other group was given normal saline (control group).The pain threshold and HAMD-17 score at each time point,extubation time,spontaneous breathing recovery time and blink time of the two groups were compared. RESULTS: The pain threshold at 1h and 2h after operation of the naloxone group were significantly higher than those of the control group(P<0.05).After operation,the HAMD-17 scores of the two groups were lower than those before the operation,and the HAMD-17 scores of the naltrexone group were significantly higher than those of the control group at 1 and 3 days after operation(P<0.05).The extinction time,spontaneous breathing recovery time and blink time of the naloxone group were significantly shorter than those of the control group(P<0.05). CONCLUSION: Naloxone can antagonize the pain sensitization caused by remifentanil anesthesia and contribute to postoperative resuscitation, but it can significantly reduce the antidepressant effect of ketamine.The acute antidepressant effect of ketamine in treating patients with depression may be an opioid system activation is required.
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| 关键词 |
抑郁症；腹腔镜手术；氯胺酮；纳洛酮
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| KeyWord |
Depression; Laparoscopic surgery; Ketamine; Naloxone
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| 基金项目 |
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| 页码 |
333-335 |
崔雪娅*.
纳洛酮用于接受氯胺酮辅助麻醉的抑郁症患者的复苏和抗抑郁作用的影响 [J].
国际精神病学杂志.
2020; 47; (2).
333 - 335.