神经药理学报

神经药理学报 ›› 2023, Vol. 13 ›› Issue (4): 13-.DOI: 10.3969/j.issn.2095-1396.2023.04.003

• 综述 • 上一篇    下一篇

艾司氯胺酮的临床应用效果及不良反应的研究进展

黄予利，李向博，袁莉，滕金亮   

  1. 1. 河北北方学院研究生学院，张家口，075000，中国 

    2. 河北北方学院附属第一医院麻醉科，张家口，075000，中国

  • 出版日期:2023-08-26 发布日期:2024-05-09
  • 通讯作者: 滕金亮，主任医师，教授，研究生导师；E-mail: tengjinliang@126.com
  • 作者简介:黄予利，河北北方学院2022级硕士研究生；E-mail: 1549492491@qq.com

Research Progress on Clinical Efficacy and Adverse Reactions of Esketamine

HUANG Yu-li，LI Xiang-bo，YUAN li，TENG Jin-liang   

  1. 1. The graduate School of Hebei North University, 075000, Zhangjiakou, China 

    2. Department of Anesthesiology, The First Clinical College of Hebei North University, 075000，Zhangjiakou, China

  • Online:2023-08-26 Published:2024-05-09
  • Contact: 滕金亮，主任医师，教授，研究生导师；E-mail: tengjinliang@126.com
  • About author:黄予利，河北北方学院2022级硕士研究生；E-mail: 1549492491@qq.com

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摘要：

艾司氯胺酮是氯胺酮的纯右旋异构体，与经典的静脉麻醉药氯胺酮相比，它与 N-甲基-D-天门冬氨酸（N-methyl-D-aspartate，NMDA）受体和阿片μ受体的亲和力更高，具有更强的镇痛效力，且呼吸抑制作用轻、心血管和精神方面不良反应发生率低等优势。它还适用于多种精神类疾病的临床治疗，如癫痫和抑郁症，有效地缓解患者的疼痛，改善患者的睡眠质量，从而达到更好的治疗效果。因其具有较强的镇痛作用、不良反应较少、镇痛剂量不影响呼吸及循环稳定，对患者精神状态、心血管系统等方面的影响也较小的这些特点，近年来在临床应用方面备受关注，逐渐成为围术期低阿片方案中重要的非阿片类药物。该文就艾司氯胺酮的的药理学特性，临床应用及不良反应进行综述。

关键词: 艾司氯胺酮, 难治性抑郁, 低阿片方案, 临床应用, 麻醉

Abstract:

Esketamine is a kind of pure dextroisomer of ketamine, compared with ketamine, the classic intravenous anesthetic, esketamine has a higher affinity to NMDA and opioid μ receptors, has stronger analgesic effect, and less respiratory depression, incidence of cardiovascular and psychiatric adverse reactions. It is also suitable for the clinical treatment of a variety of psychiatric disorders, such as epilepsy and depression. Effectively relieve patients' pain, improve patients' sleep quality, so as to achieve better treatment effect. It has gradually become an important non-opioid drug in perioperative low opioid program because of its strong analgesic effect, few adverse reactions, no influence of analgesic dose on respiratory and circulation stability, and little influence on mental state and cardiovascular system of patients. This article reviews the pharmacological properties, clinical applications and adverse reactions of esketamine.

Key words: esketamine, refractory depression, low opioid regimen, clinical application, anesthesia