Application of anesthesia induction with low-dose ketamine combined with propofol and remifentanil in endoscopic sclerotherapy for patients with esophageal varices
Objective To evaluate the safety and efficacy of anesthesia induction with low-dose ketamine combined with propofol and remifentanil in endoscopic sclerotherapy for patients with esophageal varices.Methods Sixty patients with esophageal varices undergoing endoscopic sclerotherapy were randomized into two groups,with 30 cases each.Anesthesia was induced with remifentanil 0.3 μg/kg and propofol 2 mg/kg in group P,which was induced with remifentanil 0.3 μg/kg,propofol 1 mg/kg and ketamine 0.3 mg/kg in group K.Anesthesia was maintained with propofol 4 mg·kg1·h-1 in two groups.The HR and MAP before induction(T0),after induction(T1),immediately after entering the endoscope(T2),and 5 minutes after entering the endoscope(T3)were recorded.The occurrence of respiratory depression,hypotension,severe bradycardia and body movement was recorded.Results Compared with T0,MAP and HR were decreased at T1 to T3 in group P,MAP was decreased at T1 to T3 and HR was decreased at T3 in group K(P＜0.01).The MAP and HR of group K were higher than those of group P at T1 to T3(P＜0.01).The incidence of respiratory depression in group K was lower than that in group P(P＜0.05).There was no significant difference in the incidence of hypotension and body movement between the two groups(P＞0.05).No severe bradycardia events occurred in the two groups.Conclusion In the patients with esophageal varices undergoing endoscopic sclerotherapy,anesthesia induction with ketamine 0.3 mg/kg combined with propofol and remifentanil has less circulatory and respiratory suppression.
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