马资含,郭 栋

艾司氯胺酮（Esketamine）作为氯胺酮的右旋异构体，相较于外消旋氯胺酮，艾司氯胺酮对N-甲基-D-天冬氨酸（NMDA）受体的亲和力提高了2-3倍，镇痛效价显著增强，同时精神神经系统不良反应发生率更低。本文通过系统综述艾司氯胺酮的作用机制、药理特点及其在多个临床领域的应用现状，旨在为临床医师提供更全面、更科学的用药参考，促进艾司氯胺酮在临床实践中的合理、安全使用。

艾司氯胺酮；NMDA受体；镇痛；抗抑郁；围术期麻醉；急危重症

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