CN-121987602-A - Application of esketamine in relieving postoperative delirium of general anesthesia of burn patients

CN121987602ACN 121987602 ACN121987602 ACN 121987602ACN-121987602-A

Abstract

The invention belongs to the technical field of medicines, and discloses application of esketamine in relieving delirium of burn patients after general anesthesia operation, the application is that a flax intoxication dose of esketamine load dose is given to patients who undergo burn scab removal and skin grafting operation for the period selection after general anesthesia induction and before operation, the maintenance dose is continuously infused intravenously in the operation for 30 minutes before the operation is finished, the incidence and the severity of delirium of a patient in 7 days after the operation can be effectively reduced, meanwhile, the postoperative acute pain is improved, the consumption of opioid medicines in the perioperative period is reduced, the postoperative sleep quality is improved, the incidence of adverse reactions is not obviously increased, and the safety is good. The invention provides a safe and effective new means for clinic and has important clinical application value.

Inventors

QIN XIAO
BAI GUOLIANG
LUO YUANXIN
Xing Chunping

Assignees

太原钢铁(集团)有限公司总医院

Dates

Publication Date: 20260508
Application Date: 20260323

Claims (6)

1. Use of esketamine for alleviating delirium after general anesthesia in burn patients.
2. The use according to claim 1, wherein said dosage of esketamine is a flax dose, including a loading dose of 0.25mg/kg and an intraoperative maintenance dose of 0.125mg/kg/h.
3. The use according to claim 1, wherein the burn patient is 18-65 years old, the total burn area is more than 30% or the third degree burn area is more than 10%, and ASA is classified as class II-IV, the preferred stage being a patient under general anesthesia burn scabbing dermatology.
4. The use according to claim 1, wherein said esketamine is administered by intravenous loading dose after induction of anesthesia, before the start of surgery, followed by continuous intravenous infusion at maintenance dose until 30 minutes before the end of surgery.
5. The use of claim 1, further comprising at least one of reducing the severity of delirium after general anesthesia in burn patients, reducing perioperative opioid consumption, improving postoperative acute pain conditions, or improving postoperative sleep quality.
6. The use according to claim 1, wherein said esketamine is in the form of an injectable formulation, which is administered after dilution with physiological saline to a concentration of 2.5mg/mL before use.

Description

Application of esketamine in relieving postoperative delirium of general anesthesia of burn patients Technical Field The invention belongs to the technical field of medicines, and particularly relates to application of esketamine in relieving postoperative delirium of burn patients. Background Delirium (POD) after operation is a temporary brain dysfunction which occurs acutely within 7 days after operation, takes attention disorder, consciousness level disturbance, cognitive dysfunction and the like as core characteristics, can lead to prolonged hospitalization time, increased medical cost and increased death rate after operation of patients, and can still have cognitive damage in 80% of patients within 6 months after operation, thus being a serious nervous system complication to be solved in clinical urgent need. The occurrence rate of POD after operation of burn patients is obviously higher, and related researches prove that the occurrence rate of POD is between 14.55% and 36.87%, and the occurrence risk of POD is more in an increasing trend when severe burn patients are taken as special people. At present, the pathogenesis of POD is not clear, and the prevention becomes critical due to the lack of effective treatment means. Ketamine has been shown to reduce POD occurrence prophylactically, but has psychotropic side effects and addiction risks, and has limited clinical use. The esketamine is used as the dextroisomer of ketamine, has the advantages of high in vivo clearance rate and low adverse reaction incidence rate, has the functions of strong analgesia, stable circulation and the like, and is widely applied to various operations. The existing research has inconsistent conclusion on preventing POD by esketamine, and no related research on POD after scab removal and skin grafting of burn patients exists, and key problems such as administration dosage, mode and the like are still controversial, so that the application value of esketamine in the scene is required to be clarified, and the clinical blank is filled. Disclosure of Invention In order to overcome the technical problems, the invention provides application of esketamine in relieving postoperative delirium of general anesthesia of burn patients. The invention adopts the following technical scheme: use of esketamine for alleviating delirium after general anesthesia in burn patients. Preferably, the dosage of the esketamine is a flax intoxication dosage, comprising a loading dosage of 0.25mg/kg and an intraoperative maintenance dosage of 0.125mg/kg/h. Preferably, the burn patient is 18-65 years old, the total burn area exceeds 30% or the third degree burn area exceeds 10%, ASA is classified into class II-IV, and the patient is subjected to general anesthesia downstream burn scab reduction skin grafting. Preferably, the esketamine is administered by intravenous injection of a loading dose after anesthesia induction and before the beginning of surgery, followed by continuous intravenous infusion with a maintenance dose until 30 minutes before the end of surgery. Preferably, the use further comprises at least one of reducing the severity of delirium after general anesthesia in burn patients, reducing perioperative opioid consumption, improving postoperative acute pain conditions, or improving postoperative sleep quality. Preferably, the dosage form of the esketamine is an injection dosage form, and is administered after being diluted to a concentration of 2.5mg/mL by normal saline before use. Compared with the prior art, the invention has the beneficial effects that: Can effectively reduce the incidence rate of POD of burn patients within 7 days after general anesthesia operation, simultaneously lighten the severity of POD, shorten the duration time of POD, and improve the short-term and long-term prognosis of patients. Not only can relieve postoperative acute pain and reduce consumption of opioid medicines in the perioperative period, but also can promote postoperative sleep quality of patients, improve early stage mental state after operation and comprehensively optimize postoperative rehabilitation experience. Can reduce the level of the related biomarkers of postoperative inflammatory response and nerve injury, and can assist in improving the postoperative brain function state of patients from the pathological mechanism level. Compared with ketamine, the occurrence rate of the adverse reaction of the esketamine is lower, obvious serious mental side effects are avoided, the administration dosage and the mode are clear, the esketamine is suitable for accurate people, and the clinical application risk is controllable. Provides a new effective means for preventing the POD after the general anesthesia operation of burn patients, standardizes the clinical application scene and the scheme of the esketamine, and solves the problem that the POD prevention of the patients lacks the clinical pain point of the targeted medicine. Detailed Description The embodim