{"title":"支气管内超声引导下经支气管针抽吸术中深度镇静的依西他敏联合丙泊酚 TCI 与丙泊酚 TCI 比较:前瞻性随机对照试验","authors":"Sichen Cui, Peiying Huang, Zhanxiong Wei, Ting Guo, Aiyan Zhang, Lining Huang","doi":"10.1155/2023/1155126","DOIUrl":null,"url":null,"abstract":"<i>Background</i>. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an invasive procedure that required deep sedation to suppress coughing and body movements. Deep sedation, on the other hand, has been shown to cause respiratory and circulatory depression, especially when the airway is shared with the endoscopist. Esketamine is a novel sedative and analgesic with little respiratory inhibition that appears to be an appropriate adjuvant in propofol sedation for EBUS-TBNA. We compared the efficacy and safety of esketamine combined with propofol target-controlled infusion (TCI) and propofol TCI for deep sedation in EBUS-TBNA. <i>Methods</i>. The study included 135 patients with ASA II-III undergoing EBUS-TBNA. They were randomly divided into two groups (group E and group P). Both groups received midazolam (0.01–0.03 mg/kg) and oxycodone (0.07–0.08 mg/kg). Then, patients in group E received 0.3 mg/kg esketamine, propofol TCI, and 0.2 mg·kg<sup>−1</sup>·h<sup>−1</sup> esketamine for sedative maintenance. Patients in group P received only propofol TCI. The primary outcome was the dose of 1% lidocaine administrated by the endoscopist and the times of lidocaine sprays. Secondary outcome indicators were cough score, propofol dosage, patient satisfaction, endoscopist satisfaction, the incidence of sedation-related adverse effects and side effects, and recovery time. <i>Results</i>. Patients in group E were given significantly less lidocaine (4.36 ml/h (2.67–6.00) vs 6.00 ml/h (4.36–7.20), <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>)</span></span> and less spraying frequency (2.18 times/h (1.33–3.00) vs 3.00 times/h (2.18–3.60), <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>)</span></span> than group P. There was a statistically significant difference in cough score between the two groups (group E 2 (0–4) vs group P 3 (2–4), <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 8.8423\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>).</span></span> Also, mean arterial pressure (MAP) was higher in group E in the 30<sup>th</sup> min (T5, 84.10 ± 12.91 mmHg versus 79.04 ± 10.01 mmHg, <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-34\"></use></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 8.8423\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-50\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>)</span></span> and 40<sup>th</sup> min (T6, 87.72 ± 15.55 mmHg versus 82.14 ± 10.51 mmHg, <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-34\"></use></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 8.8423\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-51\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>).</span></span> There were no significant differences between the two groups in terms of sedation-related adverse events and side effects, recovery time, endoscopist satisfaction, and patient satisfaction. <i>Conclusions</i>. In patients with ASA II-III, esketamine as an adjuvant in combination with propofol TCI deep sedation for EBUS-TBNA can improve the sedation effect, reduce coughing reaction during the procedure, and obtain more stable blood pressure. No reduction in the occurrence of sedation-related side effects was observed. This trial is registered with ChiCTR2200061124.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Esketamine Combined with Propofol TCI versus Propofol TCI for Deep Sedation during Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Prospective, Randomized, and Controlled Trial\",\"authors\":\"Sichen Cui, Peiying Huang, Zhanxiong Wei, Ting Guo, Aiyan Zhang, Lining Huang\",\"doi\":\"10.1155/2023/1155126\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Background</i>. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an invasive procedure that required deep sedation to suppress coughing and body movements. Deep sedation, on the other hand, has been shown to cause respiratory and circulatory depression, especially when the airway is shared with the endoscopist. Esketamine is a novel sedative and analgesic with little respiratory inhibition that appears to be an appropriate adjuvant in propofol sedation for EBUS-TBNA. We compared the efficacy and safety of esketamine combined with propofol target-controlled infusion (TCI) and propofol TCI for deep sedation in EBUS-TBNA. <i>Methods</i>. The study included 135 patients with ASA II-III undergoing EBUS-TBNA. They were randomly divided into two groups (group E and group P). Both groups received midazolam (0.01–0.03 mg/kg) and oxycodone (0.07–0.08 mg/kg). Then, patients in group E received 0.3 mg/kg esketamine, propofol TCI, and 0.2 mg·kg<sup>−1</sup>·h<sup>−1</sup> esketamine for sedative maintenance. Patients in group P received only propofol TCI. The primary outcome was the dose of 1% lidocaine administrated by the endoscopist and the times of lidocaine sprays. Secondary outcome indicators were cough score, propofol dosage, patient satisfaction, endoscopist satisfaction, the incidence of sedation-related adverse effects and side effects, and recovery time. <i>Results</i>. Patients in group E were given significantly less lidocaine (4.36 ml/h (2.67–6.00) vs 6.00 ml/h (4.36–7.20), <span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"></path></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 28.182 9.2729\\\" width=\\\"28.182pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.605,0)\\\"></path></g></svg>)</span></span> and less spraying frequency (2.18 times/h (1.33–3.00) vs 3.00 times/h (2.18–3.60), <span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 9.2729\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"9.2729pt\\\" style=\\\"vertical-align:-0.6370001pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 28.182 9.2729\\\" width=\\\"28.182pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.605,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g></svg>)</span></span> than group P. There was a statistically significant difference in cough score between the two groups (group E 2 (0–4) vs group P 3 (2–4), <span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 8.8423\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"></path></g></svg><span></span><span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 21.918 8.8423\\\" width=\\\"21.918pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"></path></g></svg>).</span></span> Also, mean arterial pressure (MAP) was higher in group E in the 30<sup>th</sup> min (T5, 84.10 ± 12.91 mmHg versus 79.04 ± 10.01 mmHg, <span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 8.8423\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-34\\\"></use></g></svg><span></span><span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 28.182 8.8423\\\" width=\\\"28.182pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-50\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.605,0)\\\"></path></g></svg>)</span></span> and 40<sup>th</sup> min (T6, 87.72 ± 15.55 mmHg versus 82.14 ± 10.51 mmHg, <span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -8.6359 19.289 8.8423\\\" width=\\\"19.289pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,11.658,0)\\\"><use xlink:href=\\\"#g117-34\\\"></use></g></svg><span></span><span><svg height=\\\"8.8423pt\\\" style=\\\"vertical-align:-0.2064009pt\\\" version=\\\"1.1\\\" viewbox=\\\"22.8711838 -8.6359 28.182 8.8423\\\" width=\\\"28.182pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,22.921,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,29.161,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,32.125,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,38.365,0)\\\"><use xlink:href=\\\"#g113-51\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,44.605,0)\\\"></path></g></svg>).</span></span> There were no significant differences between the two groups in terms of sedation-related adverse events and side effects, recovery time, endoscopist satisfaction, and patient satisfaction. <i>Conclusions</i>. In patients with ASA II-III, esketamine as an adjuvant in combination with propofol TCI deep sedation for EBUS-TBNA can improve the sedation effect, reduce coughing reaction during the procedure, and obtain more stable blood pressure. No reduction in the occurrence of sedation-related side effects was observed. This trial is registered with ChiCTR2200061124.\",\"PeriodicalId\":13782,\"journal\":{\"name\":\"International Journal of Clinical Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2023-12-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/1155126\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/1155126","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Esketamine Combined with Propofol TCI versus Propofol TCI for Deep Sedation during Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Prospective, Randomized, and Controlled Trial
Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an invasive procedure that required deep sedation to suppress coughing and body movements. Deep sedation, on the other hand, has been shown to cause respiratory and circulatory depression, especially when the airway is shared with the endoscopist. Esketamine is a novel sedative and analgesic with little respiratory inhibition that appears to be an appropriate adjuvant in propofol sedation for EBUS-TBNA. We compared the efficacy and safety of esketamine combined with propofol target-controlled infusion (TCI) and propofol TCI for deep sedation in EBUS-TBNA. Methods. The study included 135 patients with ASA II-III undergoing EBUS-TBNA. They were randomly divided into two groups (group E and group P). Both groups received midazolam (0.01–0.03 mg/kg) and oxycodone (0.07–0.08 mg/kg). Then, patients in group E received 0.3 mg/kg esketamine, propofol TCI, and 0.2 mg·kg−1·h−1 esketamine for sedative maintenance. Patients in group P received only propofol TCI. The primary outcome was the dose of 1% lidocaine administrated by the endoscopist and the times of lidocaine sprays. Secondary outcome indicators were cough score, propofol dosage, patient satisfaction, endoscopist satisfaction, the incidence of sedation-related adverse effects and side effects, and recovery time. Results. Patients in group E were given significantly less lidocaine (4.36 ml/h (2.67–6.00) vs 6.00 ml/h (4.36–7.20), ) and less spraying frequency (2.18 times/h (1.33–3.00) vs 3.00 times/h (2.18–3.60), ) than group P. There was a statistically significant difference in cough score between the two groups (group E 2 (0–4) vs group P 3 (2–4), ). Also, mean arterial pressure (MAP) was higher in group E in the 30th min (T5, 84.10 ± 12.91 mmHg versus 79.04 ± 10.01 mmHg, ) and 40th min (T6, 87.72 ± 15.55 mmHg versus 82.14 ± 10.51 mmHg, ). There were no significant differences between the two groups in terms of sedation-related adverse events and side effects, recovery time, endoscopist satisfaction, and patient satisfaction. Conclusions. In patients with ASA II-III, esketamine as an adjuvant in combination with propofol TCI deep sedation for EBUS-TBNA can improve the sedation effect, reduce coughing reaction during the procedure, and obtain more stable blood pressure. No reduction in the occurrence of sedation-related side effects was observed. This trial is registered with ChiCTR2200061124.
期刊介绍:
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IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.