■本研究旨在确定esketamine与异丙酚联合用于宫腔镜检查的95%有效剂量(ED95),然后评估其疗效和安全性。
■这个前景,双盲,随机对照试验由两个队列组成.在队列1中,45名年龄在18-65岁接受宫腔镜检查的女性被随机分配到E组(艾氯胺酮+丙泊酚)或A组(阿芬太尼+丙泊酚)。采用Dixon-down法测定艾氯胺酮和阿芬太尼的ED95。在队列2中,86例患者被随机分为E组和A组,与用于诱导的研究药物的计算的ED95剂量。使用ED95%剂量的麻醉成功率,以及与麻醉诱导相关的参数,recovery,并记录不良事件.
■艾氯胺酮的ED95为0.254mg/kg(95%CI:0.214-1.004),而阿芬太尼为9.121μg/kg(95%CI:8.479-13.364)。E组麻醉成功率为93.0%,A组为95.2%(p=0.664)。复苏后,两组均取得100%的成功率。E组诱导时间(60.0[55.0-70.0]s)明显短于A组(67.0[61.0-79.3]s)(p=0.006)。E组的呼吸抑制发生率较低(p<0.001),缺氧(p=0.006),围手术期最低SpO2(p=0.010),和低血压(p=0.001)。Esketamine对呼吸频率的影响较小,心率,平均血压,和呼气末二氧化碳与阿芬太尼相比(所有p<0.001)。两组术后疼痛差异无统计学意义。
■这项研究确定了在宫腔镜检查期间用于静脉全身麻醉的艾氯胺酮的ED95剂量。Esketamine显示较少的呼吸和血流动力学抑制,与阿芬太尼相比,不良反应更少。与阿芬太尼相比,依维他明是宫腔镜麻醉的理想麻醉剂。
■www.chictr.org.cn,(ChiCTR2300077283);注册于2023年11月3日。
UNASSIGNED: This study aimed to establish the 95% effective dose (ED95) of esketamine in combination with propofol for
hysteroscopy and then to evaluate its efficacy and safety profile.
UNASSIGNED: This prospective, double-blind, randomized controlled trial consisted of two cohorts. In cohort 1, 45 women aged 18-65 years undergoing
hysteroscopy were randomly assigned to either group E (esketamine + propofol) or group A (alfentanil + propofol). Dixon\'s up-and-down method was used to determine the ED95 of esketamine and alfentanil. In cohort 2, 86 patients were randomized to group E and group A, with the calculated ED95 dose of the study drugs used for induction. The success rate of anesthesia using the ED95% dose, along with parameters related to anesthesia induction, recovery, and adverse events were also recorded.
UNASSIGNED: The ED95 of esketamine was 0.254 mg/kg (95% CI: 0.214-1.004), while that of alfentanil was 9.121 μg/kg (95% CI: 8.479-13.364). The anesthesia success rate was 93.0% in group E and 95.2% in group A (p = 0.664). After resuscitation, both groups achieved a 100% success rate. The induction time was significantly shorter in group E (60.0 [55.0-70.0] s) compared to group A (67.0 [61.0-79.3] s) (p = 0.006). Group E had lower rates of respiratory depression (p < 0.001), hypoxia (p = 0.006), minimum perioperative SpO2 (p = 0.010), and hypotension (p = 0.001). Esketamine had less effect on respiratory rate, heart rate, mean blood pressure, and end-tidal carbon dioxide compared to alfentanil (all p < 0.001). There were no significant differences in postoperative pain between the two groups.
UNASSIGNED: This study determined the ED 95 dose of esketamine for intravenous general anesthesia during
hysteroscopy. Esketamine showed less respiratory and hemodynamic depression, as well as fewer adverse effects compared to alfentanil. Esketamine is an ideal anesthetic agent compared to alfentanil for hysteroscopic anesthesia.
UNASSIGNED: www.chictr.org.cn, (ChiCTR2300077283); registered November 3, 2023.