Effect of Esketamine Compared with Sufentanil Combined with Propofol in Patients Undergoing First Trimester Surgical Abortion: A Randomized, Double-Blinded Clinical Trial.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-04-13 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S515006

Yingchao Guan, Haochen Wang, Xiaojing Cong, Beibei Zhang, Yusong Lin, Xiaodong Wang

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引用次数: 0

Abstract

Background: We explored whether esketamine anesthesia during first-trimester surgical abortion can reduce intraoperative hemodynamic fluctuations and improve patients' respiratory function.

Methods: A total of 197 patients who underwent a first-trimester surgical abortion were included in the analysis. Patients were randomly assigned to either the esketamine anesthesia group (group E, n=98) or sufentanil anesthesia group (group S, n=99). The primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), heart rate (HR), respiratory rate (RR) and end-tidal carbon dioxide partial pressure (PetCO₂) during the surgery. Secondary outcomes included body movement, apnea, hypoxemia, postoperative nausea and vomiting (PONV), dizziness, anesthesia recovery time, Richmond Agitation and Sedation Scale (RASS) score, and postoperative pain.

Results: Patients in Group E had a more stable intraoperative SBP (p=0.001), DBP (p=0.014), MBP (p=0.003), and HR (p=0.001). There was no significant difference in intraoperative RR between the two groups (p=0.108); however, PetCO₂ in group E remained at preoperative levels, whereas it increased in group S during surgery (p<0.001). The risk of apnea and hypoxemia in group E was lower (RR 0.32, 95% CI [0.13, 0.76], p=0.006; RR 0.13, 95% CI [0.03, 0.54], p=0.001). The incidence of intraoperative body movement (50% vs 27%, p=0.003), postoperative dizziness (45% vs 30%, p=0.024), and nausea (7% vs 0%, p=0.007) was higher in group E. There were no differences in anesthesia recovery time, postoperative RASS score, pain, or vomiting.

Conclusion: Compared with sufentanil, esketamine anesthesia during the first trimester surgical abortion can maintain stable intraoperative hemodynamics and respiratory function during surgery and reduce apnea and hypoxemia. Esketamine may increase the risk of dizziness and PONV after surgical abortion.

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艾氯胺酮与舒芬太尼联合异丙酚在妊娠早期手术流产患者中的作用：一项随机、双盲临床试验。

背景：探讨艾氯胺酮麻醉在妊娠早期手术流产中是否能减少术中血流动力学波动，改善患者呼吸功能。方法：对197例妊娠早期手术流产患者进行分析。患者随机分为艾氯胺酮麻醉组（E组，n=98）和舒芬太尼麻醉组（S组，n=99）。主要结局是手术期间收缩压（SBP）、舒张压（DBP）、平均血压（MBP）、心率（HR）、呼吸频率（RR）和末潮二氧化碳分压（PetCO2）。次要结局包括身体运动、呼吸暂停、低氧血症、术后恶心呕吐（PONV）、头晕、麻醉恢复时间、Richmond躁动镇静量表（RASS）评分和术后疼痛。结果：E组患者术中收缩压（p=0.001）、DBP （p=0.014）、MBP （p=0.003）、HR （p=0.001）更为稳定。两组术中RR比较差异无统计学意义（p=0.108）；结论：与舒芬太尼相比，艾氯胺酮麻醉在妊娠早期手术流产时可以维持术中稳定的血流动力学和呼吸功能，减少呼吸暂停和低氧血症。艾氯胺酮可能增加手术流产后眩晕和PONV的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.