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The clinical application of subanesthetic dose of esketamine in geriatric patients with painless bronchoscopy |
JIANG Xiufang1, BAI Lu2, XU Wei1, YI Hu1, LUO Liu1, XIONG Qiangqiang1, MAO Xincheng1, ZHENG Mingzhi1, QI Mingming1 |
1. Department of Anesthesiology, Zhuzhou Hospital Affiliated to Xiangya Medical College of Central South University, Zhuzhou 412000, China; 2. Department of Anesthesiology, The Second Affiliated Hospital of Guangdong Medical University, Guangzhou 510260, China |
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Abstract Objective To investigate the effect of flax intoxication dose of Ketamine on hemodynamics in painless fiberoptic bronchoscopy in geriatric patients. Methods A total of 100 geriatric patients undergoing painless bronchoscopy from November 2021 to May 2022 were selected and randomly divided into control group and experimental group. The experimental group was given intravenous injection of 0.15 mg/kg esmketamine hydrochloride, while the control group was given intravenous injection of equal volume of normal saline, and then the patients in both groups were given TCI pump injection of propofol and remifentanil for anesthesia induction and maintenance. When the patient's consciousness disappeared and the BIS value was less than 60, the laryngeal mask was placed and connected to the anesthesia machine for mechanical ventilation, and the BIS value was maintained at 40~60 during operation. The hemodynamic changes at different time points, the time standardized dosage of propofol and remifentanil, the incidence of adverse reactions, the use rate of vasoactive drugs, anesthesia time and postoperative recovery index monitoring scores of the two groups were observed. Results SBP and DBP in the two groups before laryngeal mask insertion (T1), during examination (T2), and at awakening (T3) were lower than those before induction of anesthesia (T0); The SBP and DBP of the experimental group at T1, T2 and T3 were higher than those of the control group at the same time. The HR of the control group at T1 and T2 was lower than that at T0; the HR of the experimental group at T1 was lower than that at T0, and the HR of the experimental group at T2 was slightly higher than that at T0. To the recovery period, the HR of the two groups was higher than that at T0; Compared with T0, SpO2 at T1, T2 and T3 increased in both groups; There was no difference in HR and SpO2 between the two groups at the same time. Conclusion Anesthesia dose of esmketamine used in geriatric patients with painless fiberoptic bronchoscopy has little impact on hemodynamics and high safety, which is worthy of promotion and application.
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Received: 26 February 2023
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