目的 探索亚麻醉剂量艾司氯胺酮对腹腔镜疝修补术患者苏醒期躁动的影响。 方法 选取全麻下行腹腔镜疝修补术的男性患者72例，随机分为亚麻醉剂量艾司氯胺酮组（AS组）和对照组。AS组手术结束前30 min静脉注射0.2 mg/kg艾司氯胺酮，对照组给予同体积生理盐水。手术结束后患者直接送入麻醉恢复室（PACU）。记录拔管时间，拔管即刻、拔管10 min、拔管30 min、拔管1 h、拔管4 h血流动力学变化，采用躁动-镇静评分（RASS）和视觉模拟评估量表（VAS）对上述时间点患者躁动-镇静和疼痛评估，意识模糊评分量表（CAM-ICU）记录患者苏醒期间谵妄发生率，PACU留观时间，术后24 h采用40项恢复质量量表评分（QoR-40）评估恢复质量及不良事件。 结果 与对照组相比，AS组患者拔管10 min后HR、MAP较高，且HR、MAP随时间的变化更为稳定（P < 0.05）；AS组在拔管即刻及后续各时间点的RASS、VAS评分均显著低于对照组（P < 0.05），两组的RASS、VAS评分都会随时间变化（P < 0.05），但AS组的变化过程更为平稳（P < 0.05）；与对照组相比，AS组患者术后拔管时间、PACU留观时间、术后谵妄、呼吸抑制、恶心呕吐差异无统计学意义（P > 0.05），恢复质量显著提升（P < 0.05）。 结论 亚麻醉剂量艾司氯胺酮能减轻腹腔镜疝修补术后患者疼痛和苏醒期躁动，同时维持患者在PACU中血流动力学的稳定，提高复苏质量，值得临床推广。

Objective To investigate the effect of subanesthetic dose of esketamine on emergence agitation （EA） in patients undergoing laparoscopic hernia repair. Methods Seventy?two male patients who treated with laparoscopic hernia repair under general anesthesia were randomly divided into AS group （subanesthetic esketamine） and control group. In the AS group， 0.2 mg/kg of esketamine was administered intravenously 30 minutes before the surgery ended， while the control group was given an equal volume of normal saline. Upon surgery completion， patients were transferred to PACU with endotracheal tube retained， and the time to extubation was recorded. Hemodynamic parameters were measured immediately after extubation and at 10 min， 30 min， 1 h， and 4 h thereafter. Patients′ pain and sedation levels were assessed at the above time points using RASS and VAS， respectively. The incidence of EA was evaluated using the Confusion Assessment Method for the Intensive Care Unit （CAM?ICU）. Observation duration in the PACU and recovery outcomes within 24 hours postoperatively were assessed via the QoR?40 and adverse events were recorded. Results Compared to those in the control group， patients in the AS group had higher HR and MAP at 10 min post?extubation， and the changes in HR and MAP over time were more stable（P < 0.05）. The RASS and VAS scores in the AS group were significantly lower than those in the control group at the time of extubation and all subsequent time points（P < 0.05）， both groups showed temporal changes in RASS and VAS scores （P < 0.05）， but the change process in the AS group was more stable（P < 0.05）. Postoperative extubation time， PACU observation duration， and adverse event rates （delirium， respiratory depression， nausea and vomiting） did not differ significantly between the two groups （P > 0.05）， while recovery quality was markedly better in the AS group （P < 0.05）. Conclusion Subanesthetic esketamine effectively alleviates pain and the incidence of EA， supports hemodynamic stability during PACU stay， and enhances recovery quality in patients undergoing laparoscopic hernia repair， demonstrating clinical value.