AI Article Synopsis
- This study evaluated how esketamine affects the relationship between remifentanil dosage and cardiovascular responses during endotracheal intubation under general anesthesia with propofol.
- Patients aged 18-65 were divided into two groups: one received esketamine before anesthesia, while the other received saline.
- Results showed that esketamine significantly lowered the effective concentration (EC) of remifentanil needed to manage cardiovascular responses during intubation compared to the control group.
Article Abstract
Background: This study aimed to investigate the effect of esketamine on the dose-effect relationship between remifentanil and the cardiovascular response to endotracheal intubation during target-controlled infusion (TCI) of propofol.
Methods: Patients underwent elective gynecological laparoscopic surgery under general anesthesia with endotracheal intubation, aged 18-65 years, American Society of Anesthesiologists class I or II, 18 kg/m ≤ body mass index ≤ 30 kg/m, were randomly divided into the control (group C) and esketamine groups (group E). Before anesthesia induction, group E received an intravenous injection of 0.3 mg/kg of esketamine, while group C received an equal dose of physiological saline. TCI of propofol to the effect-site concentration (EC) of 3.0 μg/mL, and then TCI of remifentanil to the effect room and intravenous injection of rocuronium 0.6 mg/kg after MOAA/S was 0. Endotracheal intubation was performed after 2 min. Dixon's modified sequential method was used, and the initial EC of remifentanil was 3.0 ng/mL. The EC of remifentanil was determined according to the intubation response of the previous patient, with an adjacent concentration gradient of 0.3 ng/mL. The EC and EC values and their 95% confidence intervals (CIs) were determined using probit regression analysis.
Results: The EC for cardiovascular response inhibition to endotracheal intubation using remifentanil was 3.91 ng/mL (95% CI: 3.59-4.33 ng/mL) and EC was 4.66 ng/mL (95% CI: 4.27-6.23 ng/mL) with TCI of propofol 3.0 μg/mL. After intravenous administration of 0.3 mg/kg of esketamine, the EC of remifentanil was 3.56 ng/mL (95% CI: 3.22-3.99 ng/mL) and EC was 4.31 ng/mL (95% CI: 3.91-5.88 ng/mL).
Conclusions: Combined with TCI of propofol 3.0 μg/mL for anesthesia induction, esketamine significantly reduced the EC and EC of remifentanil to inhibit the cardiovascular response to endotracheal intubation.
Trial Registration: The trial was registered in the Chinese Clinical Trials Registry ( www.chictr.org.cn ; registration number: ChiCTR2200064932; date of registration:24/10/2022).
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10880282 | PMC |
| http://dx.doi.org/10.1186/s12871-024-02454-4 | DOI Listing |
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