Application of esketamine combined with propofol in Hysteroscopy of obese patients
Objective To observe the anesthetic effect of esketamine combined with propofol in hysteroscopy of obese patients.Methods A total of Sixty patients,aged 20-60 years old,with BMI 30 kg/m-40 kg/m2,ASA grade II or Ⅲ,who underwent elective painless hysteroscopy from January to June 2022 were randomized into 2 groups,Esketamine-Propofol group(group E)and Sufentanil-propofol group(group S),with 30 patients in each group.Group E were slowly given esketamine 0.25 mg/kg followed by propofol 1.0 mg/kg intravenously,while group S was slowly injected with sufentanil 0.1 μg/kg followed by slow intravenous propofol 1.0 mg/kg.HR,SBP,DBP and SpO2 were recorded immediately after anesthesia,during operation and after recovery.The onset time of anaesthesia,the num-ber of additional cases of propofol,the time of recovery,the residence time of resuscitation room,and the digital analog score(NRS)of uterine pain at 5,15,25 min after recovery were recorded.Moreover,the adverse reactions such as propofol injection pain,jaw support,body movement,dizziness,nausea,vomiting and coughing were recorded.Results Compared with the beginning of anesthesia immedi-ately,HR,SBP and DBP were significantly decreased between the two groups immediately after admission and immediately after recov-ery(P＜0.05),while SpO2 had no statistical difference(P＞0.05).There was no significant difference in the changes of vital signs be-tween two groups at different times(P＞0.05).Compared with group S,the recovery time and dwell time of resuscitation room in group E were significantly shortened(P＜0.05),the supplemental rate and total amount of propofol were significantly reduced(P＜0.05),and the degree of uterine contraction pain was significantly decreased 25 minutes after recovery(P＜0.05).There was no statistical significance in the onset time of anesthesia between two groups(P＞0.05).Compared with group S,the incidence of jaw support,body movement,bradycardia,nausea and vomiting in group E was significantly decreased(P＜0.05),and there was no statistical signifi-cance in pain,dizziness and cough after propofol injection between the two groups(P＞0.05).Conclusion Esketamine combined with propofol can improve the anesthesia and postoperative analgesic,accelarate postoperative recovery,strengthen the postoperative anesthesia,and adverse reactions are mild.
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