关键词: 腹腔镜；胆囊切除术；艾司氯胺酮；瑞芬太尼；镇痛

Abstract: Objective To explore the analgesic effect of low-dose ketamine combined with remifentanil after laparoscopic cholecystectomy(LC).Methods This study was a prospective study.A total of 114 patients who underwent LC in hospital from June 2022 to June 2023 were selected and randomly divided into two groups by computer-generated random number table method:low-dose group and conventional-dose group,with 57 cases in each group,they were treated with esketamine 0.5 and 1 mg/kg combined with remifentanil for patient controlled intravenous analgesia(PCIA),respectively.The PCIA press times,the pain after surgery,adverse reactions were compared between the two groups.Results The comparison of PCIA press times,the visual analogue scale(VAS) pain scores at 2,8,12,24,and 48 hours after surgery between the low-dose group and the conventional-dose group [(3.16±0.63)times vs(3.14±0.65)times,(2.65±0.67) vs(2.63±0.69),(3.01±0.56) vs(3.05±0.70),(3.58±0.67) vs(3.60±0.69),(2.93±0.37) vs(2.95±0.30),(2.04±0.52) vs(2.06±0.59)] showed no statistically significant difference(P>0.05).The incidence of hallucinations and increased heart rate in the low-dose group was lower than that in the conventional-dose group(0 vs 10.53%,1.75% vs 14.04%)(P＜0.05).Conclusion The analgesic effect of small dose esketamine combined with remifentanil after LC are comparable to those of conventional dose,but the former is safer.

Key words: aparoscopy;cholecystectomy;ketamine;remifentanil;analgesic