Effect of minimum dose of Esketamine combined with Dexmedetomidine on resuscitation and sore throat after general anesthesia
JIN Yongqiang ZHANG Nini ZHOU Wenfeng ZHANG Lei GUO Lin TANG Jing
Department of Anesthesiology,Guangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangdong Province,Guangzhou 510700,China
Abstract:Objective To explore the effect of minimum dose of Esketamine combined with Dexmedetomidine on resuscitation and sore throat after general anesthesia.Methods A total of 90 patients who underwent elective endotracheal intubation in the Department of Anesthesiology,the Fifth Affiliated Hospital of Guangzhou Medical University from October 2020 to June 2021 were selected as the research subjects,and were divided into control group(n=45)and observation group(n=45)according to random number table method.The control group was continuously pumped with Remifentanil and Dexmedetomidine,while the observation group was continuously pumped with the lowest dose of Esketamine and Dexmedetomidine.The recovery time and extubation time were compared between the two groups.The changes of circulatory indexes in two groups were observed before administration(T0),at extubation(T1),and at 0.5 h(T2)and 1 h(T3)after administration.Ricker sedative-agitation score(SAS)was compared between the two groups after awakening.The related complications in the resuscitation period of patients in the two groups were analyzed.The visual analogue scale(VAS)score of wound at exit,6 h after surgery and the VAS score of sore throat at 12 h after surgery were evaluated.Results There were no significant differences in the recovery time and extubation time between two groups(P>0.05).The HR of observation group at T2 and T3 were higher than those of control group,the differences were statistically significant(P<0.05).There was no significant difference in MAP between the two groups at each time point(P>0.05).There was no significant difference in SAS score between two groups after awakening(P>0.05).There were no drug-related complications in the recovery period in both groups.There was no significant difference in VAS score between the two groups at exit and 6 h after surgery(P>0.05).While the sore throat VAS score at 12 h after operation in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The minimal dose Esketamine and Dexmedetomidine intravenous injection does not affect the recovery time and extubation time of patients,and stabilizes the cardiovascular system.There are no psychotic side effects.It can also effectively inhibit postoperative wound pain and sore throat.In the recovery period of anesthesia,the administration scheme can be used as an alternative to opiates,which is worth clinical reference.
靳永强;张妮妮;周文凤;张雷;郭林;唐靖. 最低剂量艾司氯胺酮联合右美托咪定对全麻术后患者复苏效果和咽喉痛的影响[J]. 中国当代医药, 2022, 29(10): 5-09.
JIN Yongqiang ;ZHANG Nini ;ZHOU Wenfeng ;ZHANG Lei ;GUO Lin ;TANG Jing. Effect of minimum dose of Esketamine combined with Dexmedetomidine on resuscitation and sore throat after general anesthesia. 中国当代医药, 2022, 29(10): 5-09.
Jauncey M,Nielsen S.Naloxone for opioid toxicity and overdose in the community[J].Aust Prescr,2021,44(2):38-39.
[1]
Mahiswar AP,Dubey PK,Ranjan A.Comparison be tween dexmedetomidine and fentanyl bolus in attenuating the stress response to laryngoscopy and tracheal intubation:a randomized double-blind trial[J].Braz J Anesthesiol,2021,72(1):103-109.
[2]
Elmeligy MSM,Elmeliegy MFM.Effect of Magnesium Sulfate Nebulization on Stress Response Induced Tracheal Intubation;Prospective,Randomized Study[J].Open J Anesthesiol,2021,11(4):128-135.
[3]
Lee J,Lee YC,Son JD,et al.The effect of lidocaine jelly on a taper-shaped cuff of an endotracheal tube on the postoperative sore throat:a prospective randomized study:A CONSORT compliant article[J].Medicine(Baltimore),2017,96(37):122-126.
[4]
Sulser S,Ubmann D,Brueesch M,et al.The C-MAC video laryngoscope compared with conventional laryngoscopy for rapid sequence intubation at the emergency department:study protocol[J].Scand J Trauma Resusc Emerg Med,2015,4(24):23-38.
Brian AB.Toxicities of opioid analgesics:respiratory depression,histamine release,hemodynamic changes,hypersensitivity,serotonin toxicity[J].Arch Toxicol,2021,95(8):10-16.
[6]
Luz M,Mash DC.Evaluating the toxicity and therapeutic potential of ibogaine in the treatment of chronic opioid abuse[J].Expert Opin Drug Metab Toxicol,2021,17(9):1019-1022.
[8]
Bornemann CH,Wejbora M,Michaeli K,et al.The effects of minimal-dose versus low-dose S-ketamine on opioid consumption,hyper-algesia and postoperative delirium:a tripleblinded,randomized,active and placebo controlled clinical trial[J].Minerva Anestesiol,82(10):1069-1076.
Snijdelaar DG,Cornelisse HB,Schmid RL,et al.A randomised,controlled study of peri-operative low doses(+)-ketamine in combination with postoperative patient-controlled s(+)-ketamine and morphine after radical prostatectomy[J].Anaesthesia,2020,59(3):222-228.
Choi J,Kim S.Delayed awakening time from general anesthesia for dental treatment of patients with disabilities[J].J Dent Anesth Pain Med,2021,21(3):219-226.
Kim YU,Cho BH,Cho HR.Comparison of Intracuff Pressure and Postoperative Sore Throat Following Use of Laryngeal Mask Airway Protector With or Without Nitrous Oxide Anesthesia[J].J Perianesth Nurs,2021,36(3):247-252.