Study on prevention of post-induction hypotension using esketamine in patients with ischemic stroke undergoing colorectal cancer surgery
Objective To investigate the preventive effect of esketamine on hypotension in colorectal cancer surgery after induction of general anesthesia in patients with ischemic stroke and its safety.Methods In this study,140 patients with ischemic stroke undergoing laparoscopic radical surgery for colorectal cancer between July 2023 and December 2023 in Tianjin People's Hospital were selected as the subjects.According to the random sampling method,they were divided into the control group(n=70)and the observation group(n=70).The patients in the control group were given conventional anesthesia and those in the observation group were given esketamine on the basis of conventional anesthesia.The incidence of post-induction hypotension(PIH)after anesthesia induction was recorded.Meanwhile,the mean arterial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T0),before endotracheal intubation(T1),1 min after endotracheal intubation(T2),15 min after induction(T3),and 20 min after induction(T4).The adverse reaction rate was compared between the two groups.Results The PIH in the observation group was lower than that in the control group before intubation(T1)and after intubation(T2,T3,T4),and the differences were statistically significant(χ2=4.766,3.897,3.962,4.743,all P<0.05).Comparison within the group showed that the observation group had the highest incidence of PIH at T1 and the lowest incidence at T4,while the control group had a significantly lower PIH incidence after endotracheal intubation compared to before,with statistical significance(P<0.05).For comparison with the baseline level of T0,the MAP and HR of the two groups were significantly reduced at T1,T2,T3,T4(P<0.05).At T1,T2,T3,and T4,the MAP of the observation group((84.1±12.0)mm Hg,(84.8±11.2)mm Hg,(85.0±11.8)mm Hg,(87.8±11.9)mm Hg)were higher than those of the control group((78.4±13.1)mm Hg,(80.8±12.8)mm Hg,(81.8±13.3)mm Hg,(83.0±14.5)mm Hg)(all P<0.05).The HR of the observation group was lower than that of the control group at T1((64.8±10.6)times·min-1 vs(65.6±12.6)times·min-1)),and the difference was statistically significant(P<0.05).There were no statistically significant differences of HR between the two groups at T0,T2,T3 and T4(P>0.05).The incidence of severe bradycardia in the observation group was 4.3%(3/70),which was lower than that of 14.3%(10/70)in the control,and the difference was statistically significant(χ2=20.660,P<0.05).Conclusion In ischemic stroke,the application of esketamine helps to reduce the amount of propofol and maintain the hemodynamic stability of patients more effectively,thus reducing the risk of post-induction hypotension.
EsketaminePost-induction hypotensionIschemic strokeColorectal cancer
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