Objective To observe the efficacy of low-dose esketamine in the patients undergoing lumbar fusion under general anesthesia.Methods Sixty patients undergoing lumbar fusion under combined venous-inhalation general anesthesia were randomly divided into two groups with 30 cases each.During anesthesia induction,esketamine 0.2 mg/kg was injected intravenously,which was followed by 2 μg·kg-1·min-1 intravenously pumping until the end of the operation in group A,while equal amount of normal saline instead of esketamine was given in group C as the control.The changes of MAP and HR were compared between the two groups.Serum levels of IL-6 and cortisol(Cor)were detected and VAS pain scores were evaluated before anesthesia induction and at 5 minutes after extubation.The relevant perioperative indicators and the occurrence of postoperative adverse reactions were recorded.Results Compared with group C,MAP and HR before intubation were increased,which immediately after extubation were decreased in group A(P＜0.05).Serum levels of IL-6 and Cor and VAS pain score during coughing at 5 minutes after extubation were lower in group A than those in group C(P＜0.05 or P＜0.01).Compared with group C,perioperative sufentanil and propofol consumptions and proportion of remedial analgesia were lower,while proportion of using drugs raising blood pressure and incidence of dizziness and headache after operation were higher in group A(P＜0.05 or P＜0.01).Conclusion The application of small-dose esketamine is beneficial to maintain circulatory stability in the patients undergoing lumbar fusion under general anesthesia,which has the advantages of reducing stress response and postoperative pain,but we should be alert to the possible cardiovascular and neurological adverse events associated with intravenous pumping of esketamine.
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