Objective To observe the efficacy and safety of esketamine combined with propofol in critically ill patients undergoing painless fiberoptic bronchoscopy(FOB).Methods A total of 80 critically ill patients who underwent painless FOB from February 2021 to October 2022 were selected and divided into control group and observation group according to the random number table method,with 40 cases in each group.Both groups were intravenously pumped with propofol for anesthesia induction,the control group was intravenously injected with fentanyl,and the observation group was intravenously injected with esketamine.The systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),respiratory rate(RR)and peripheral capillary oxygen saturation(SpO2)were compared between the two groups at different times;the levels of interleukin-6(IL-6)and C-reactive protein(CRP)before intervention and 8 h after intervention were compared between the two groups;the incidence of adverse events was compared between the two groups.Results At 1 min after intravenous injection of fentanyl or esketamine(T1)and 5 min after the end of the examination(T3),the SBP,DBP,HR and RR in the observation group were higher than those in the control group(P＜0.05);when bronchoscopy is placed near the tracheal carina(T2),the SBP,HR and RR in the observation group were lower than those in the control group(P＜0.05);from T,to T3,the SpO2 in the observation group was higher than that in the control group(P＜0.05).Before and 8 h after intervention,there were no significant differences in IL-6 and CRP levels between the two groups(P＞0.05).The incidences of hypotension,bradycardia,low oxygen saturation and decreased RR rate in the observation group were lower than those in the control group(P＜0.05);there were no significant differences in the incidences of suffocation reaction,cough reaction and body movement reaction between the two groups(P＞0.05).Conclusion The esketamine combined with propofol in bedside painless FOB of critically ill patients in ICU has significant effect,with more stable hemodynamics and lower incidence of adverse reactions.
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