BMC Anesthesiology最新文献

{"title":"Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial.","authors":"Kartik Syal, Ankita Chandel, Manjit Singh Kanwar","doi":"10.1186/s12871-024-02752-x","DOIUrl":"10.1186/s12871-024-02752-x","url":null,"abstract":"<p><strong>Background: </strong>The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula.</p><p><strong>Aim: </strong>To determine the minimum effective caudal local anesthetic dose using ultrasound guidance.</p><p><strong>Methods: </strong>Study was performed at two centres and at each centre, 50 pediatric patients (Total 100 patients), aged 1 to 3 years, undergoing below umbilical surgeries were included and randomised into two groups of 25 each (Total 50) to receive ultrasound guided drug volume vs. Armitage formula based volume. The volume required to reach T10 level was assessed with ultrasound in one group. Also, maximum height achieved, cutaneous level achieved after 15 min, FLACC scores 30 min post extubation and parental satisfaction scores were noted.</p><p><strong>Results: </strong>The mean drug volume required to reach T10 level in Group U was 0.755 ± 0.053 ml/kg with a P value < 0.001. (Compared to the drug volume of 1 ml/kg using one sample t test). The highest level achieved in both groups were calculated as the mode value of T8 and T7 in Group U and Group A respectively. The highest cutaneous level achieved after 15 min was also calculated as the mode value of T4 in both groups. FLACC scores at 30 min were also comparable. Satisfaction scores were comparable in both groups.</p><p><strong>Conclusion: </strong>A volume of 0.7 ml/kg of local anaesthetic in pediatric caudal block is sufficient to achieve a target of T10 level for infraumblical surgeries.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"401"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Current ventilation practice during general anaesthesia: a retrospective audit in Melbourne, Australia.","authors":"Dharshi Karalapillai, Laurence Weinberg, Jonathan Galtieri, Neil Glassford, Glenn Eastwood, Jai Darvall, Jake Geertsema, Ravi Bangia, Jane Fitzgerald, Tuong Phan, Luke OHallaran, Adriano Cocciante, Stuart Watson, David Story, Rinaldo Bellomo","doi":"10.1186/s12871-024-02760-x","DOIUrl":"10.1186/s12871-024-02760-x","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"400"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evaluation of endotracheal tube cuff pressure in pediatric patients by subjective inflation techniques: a prospective observational study.","authors":"Darunee Sripadungkul, Nawaporn Tanasoontornsut, Prathana Wittayapairoch, Thitinuch Ruenhunsa, Peerapong Sangsungnern, Cattleya Kasemsiri, Nathee Maneewan, Sutida Boonkamjad","doi":"10.1186/s12871-024-02780-7","DOIUrl":"10.1186/s12871-024-02780-7","url":null,"abstract":"<p><strong>Background: </strong>Cuffed endotracheal tubes (ETTs) are commonly used in pediatric patients, with the gold standard for measuring cuff pressure being a cuff pressure manometer. However, this equipment is not always available in every operating room. Subjective inflation techniques, such as the minimal occluding volume (MOV) technique and the stethoscope-guided (Steth) technique, offer convenient and safe alternatives to standard methods but do not provide quantitative measurements. This study aimed to evaluate ETT cuff pressures and volumes of air inflated using the two subjective techniques (MOV and Steth) in pediatric patients.</p><p><strong>Methods: </strong>This prospective observational study was conducted at the Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Thailand. We included healthy pediatric patients aged 2 to 7 years undergoing elective surgeries under general anesthesia with a cuffed ETT. The primary objective of this study was to compare the mean ETT cuff pressures and volumes of air inflated using the two subjective inflation techniques (MOV and Steth method). The secondary objectives include identifying factors associated with inappropriate inflation and evaluating post-intubation complications.</p><p><strong>Results: </strong>Sixty-four pediatric patients were analyzed. The overall mean ETT cuff pressure was 26.52 ± 8.68 cmH₂O. The target was achieved in 46.88% of patients, with overinflation in 32.81% and underinflation in 20.31%. The mean ETT cuff pressure in the MOV group was 27.77 ± 8.89 cmH₂O and in the Steth group was 25.33 ± 8.34 cmH₂O, with a non-significant mean difference of 2.44 cmH₂O (95% CI [-1.89, 6.77], p = 0.264). The mean volume of air inflated in the MOV group was 0.78 ± 0.25 ml, and in the Steth group was 0.68 ± 0.22 ml, with a non-significant mean difference of 0.10 ml (95% CI [-0.01, 0.22], p = 0.084). Younger age, lower weight, and shorter height were significantly associated with an increased risk of overinflation. An ETT size with an internal diameter (ID) of 5 mm was significantly associated with an increased risk of underinflation. No post-intubation complications were reported.</p><p><strong>Conclusions: </strong>Subjective inflation techniques (MOV or Steth) achieve target ETT cuff pressures in less than 50%, and carry the risks of both overinflation and underinflation, even without post-intubation complications.</p><p><strong>Trial registration: </strong>TCTR20211016001 (registered with the Thai Clinical Trials Registry on October 16, 2021).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"399"},"PeriodicalIF":2.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice and challenges related to regional anesthesia in Amhara regional hospitals, Northwest-Ethiopia: a web-based survey study.","authors":"Belete Muluadam Admassie, Biruk Adie Admass, Debas Yaregal Melesse","doi":"10.1186/s12871-024-02783-4","DOIUrl":"10.1186/s12871-024-02783-4","url":null,"abstract":"<p><strong>Background: </strong>Regional anesthesia (RA) can improve patient outcomes and reduce perioperative complications including deaths. Despite its benefits, RA is less utilised in low-resource settings. The purpose of this study was to assess practice and challenges related to RA in Amhara Regional Hospitals, Northwest-Ethiopia.</p><p><strong>Methods: </strong>A web- based survey was distributed among 360 anesthetists working in Amhara Regional Hospitals, Northwest-Ethiopia from November 15 - January 30, 2023. An English, semi-structure, self-administered questionnaire was disseminated by email and telegram following ethical clearance. The survey included questions about the use of RA, socio-demographic characteristics of anesthetist, types of practiced regional blocks, and barriers to perform RA. All volunteer respondents who filled online questionnaire during study period were included. The data were coded and analyzed using statistical package for social Sciences (SPSS) software-version 20. Both inferential and descriptive statistics were used to describe the results.</p><p><strong>Results: </strong>The overall response rate was 63.3% (223 out of 360 completed surveys). A total of 132 respondents (36.7%) did not provide a response, and 5 respondents (1.4%) submitted incomplete) surveys. The most frequently self-reported barriers to performing peripheral nerve blocks were a lack of equipment (regional procedure kit including block needle, ultrasound, nerve stimulator, or epidural set) 185 (82.9%), lack of knowledge 171(76.7%), lack of practical skills 112 (50.2%), and lack of drugs/medication 50 (22.4%).</p><p><strong>Conclusions: </strong>The principal findings indicate that all respondents perform spinal anaesthesia, while the practice of peripheral RA varies. Reported barriers to performing RA are related to knowledge and training, as well as a lack of equipment (there aren't enough regional procedure kits available that include an epidural set, block needle, nerve stimulator, and ultrasound). A more stringent approach with specific requirements, distinguishing between neuraxial and peripheral blocks, enhance training opportunities for peripheral nerve blocks are required in Ethiopia.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"398"},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe postoperative negative pressure pulmonary edema: a case report.","authors":"Philipp Kazuo Omuro, David Sander, Dominique Hart","doi":"10.1186/s12871-024-02785-2","DOIUrl":"10.1186/s12871-024-02785-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative negative pressure pulmonary edema (NPPE) can occur in any patient undergoing general anesthesia. There are several risk factors for it, especially postoperative laryngospasm. The disease is usually benign and quickly reversible. In our case the severity and need for advanced critical care therapy was unusual.</p><p><strong>Case: </strong>We report a severe case of postoperative negative pressure pulmonary edema in a 62-year-old male patient undergoing elective right-sided retroperitoneoscopic adrenalectomy. The patient developed a severe case of acute respiratory distress syndrome (ARDS) after postoperative laryngospasm, possibly in conjunction with a suspected anaphylactic reaction. The patient was consequently treated with a combination of invasive airway pressure release ventilation (APRV) and a prone positioning regimen. After drastic improvement in respiratory function, the patient was discharged from the intensive care unit after 10 days and from the hospital after 14 days.</p><p><strong>Conclusion: </strong>NPPE is a rare but relevant complication of anesthesia and laryngospasm. The disease can basically occur in any patient undergoing general anesthesia and therefore should be considered.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"397"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of ciprofol for general anesthesia induction in female patients with frailty: a prospective randomized controlled trial.","authors":"Yu Wei, Lijie Jia, Shiping Cheng, Wei Ma, Xiaohu An, Zifeng Xu","doi":"10.1186/s12871-024-02776-3","DOIUrl":"10.1186/s12871-024-02776-3","url":null,"abstract":"<p><strong>Background: </strong>Ciprofol, a recently developed anesthetic agent, is not inferior to propofol in terms of efficacy and safety. However, most previous clinical experience with ciprofol was based on a robust population. This study aimed to investigate the efficacy and safety of ciprofol for anesthesia induction in female patients with frailty.</p><p><strong>Methods: </strong>This prospective randomized controlled trial included patients with frailty undergoing elective general anesthesia for gynecological surgery. Frailty was assessed using the modified frailty index. The patients were randomly administered propofol (2 mg/kg) or ciprofol (0.5 mg/kg) during anesthesia induction. The depth of anaesthesia was continually monitored by the bispectral index. The primary outcome was the lowest systolic blood pressure (SBP) during anesthesia induction. Secondary outcomes included the incidence of general anesthesia induction failure and adverse events.</p><p><strong>Results: </strong>Among the 69 enrolled patients with frailty, 67 were included in the final analysis. The success rate of anesthesia induction was 100% in both groups. The lowest SBP was significantly higher in the ciprofol group than in the propofol group (103 [96-110] vs. 90 [85-98] mmHg, respectively; P < 0.001), suggesting that the former caused less inhibition of hemodynamics during anesthesia induction in patients with frailty. The incidence of injection pain was lower in the ciprofol group than in the propofol group (3 [8.8%] vs. 11 patients [33.3%], respectively; P = 0.014).</p><p><strong>Conclusions: </strong>The results of this study suggest that the efficacy of ciprofol for inducing general anesthesia in patients with frailty is comparable to that of propofol, with more stable hemodynamics.</p><p><strong>Trial registration: </strong>The trial was registered, before patient enrollment, in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) (Clinical trial number: ChiCTR2300075271; https://www.chictr.org.cn/showproj.html?proj=205160 , principal investigator's name: Zifeng Xu, date of registration: 31/08/2023).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"396"},"PeriodicalIF":2.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative short-term blood pressure variability and postoperative acute kidney injury: a single-center retrospective cohort study using sample entropy analysis.","authors":"Ryan Folks, Siny Tsang, Donald E Brown, Zachary D Blanks, Nazanin Moradinasab, Michael Mazzeffi, Bhiken I Naik","doi":"10.1186/s12871-024-02784-3","DOIUrl":"10.1186/s12871-024-02784-3","url":null,"abstract":"<p><strong>Background: </strong>To investigate if intraoperative very short-term variability in blood pressure measured by sample entropy improves discrimination of postoperative acute kidney injury after noncardiac surgery.</p><p><strong>Methods: </strong>Adult surgical patients undergoing general, thoracic, urological, or gynecological surgery between August 2016 to June 2017 at Seoul National University Hospital were included. The primary outcome was acute kidney injury stage 1, defined by the Kidney Disease: Improving Global Outcomes guidelines. Exploratory and explanatory variables included sample entropy of the mean arterial pressure and standard demographic, surgical, anesthesia and hypotension over time indices known to be associated with acute kidney injury respectively. Random forest classification and L1 logistic regression were used to assess four models for discriminating acute kidney injury: (1) Standard risk factors which included demographic, anesthetic, and surgical variables (2) Standard risk factors and cumulative hypotension over time (3) Standard risk factors and sample entropy (4) Standard risk factors, cumulative hypotension over time and sample entropy.</p><p><strong>Results: </strong>Two hundred and thirteen (7.4%) cases developed postoperative acute kidney injury. The median and interquartile range for sample entropy of mean arterial pressure was 0.34 and [0.26, 0.42] respectively. C-statistics were identical between the random forest and L1 logistic regression models. Results demonstrated no improvement in discrimination of postoperative acute kidney injury with the addition of the sample entropy of mean arterial pressure: Standard risk factors: 0.81 [0.76, 0.85], Standard risk factors and hypotension over time indices: 0.80 [0.75, 0.85], Standard risk factors and sample entropy of mean arterial pressure: 0.81 [0.76, 0.85] and Standard risk factors, sample entropy of mean arterial pressure and hypotension over time indices: 0.81 [0.76, 0.86].</p><p><strong>Conclusion: </strong>Assessment of very short-term blood pressure variability does not improve the discrimination of postoperative acute kidney injury in patients undergoing non-cardiac surgery in this sample.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"395"},"PeriodicalIF":2.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative acute psychological complications following dental procedures under general anesthesia in uncooperative children.","authors":"Elham Farokh Gisour, Fatemeh Heidari, Amir Hossein Nekouei, Fatemeh Jahanimoghadam","doi":"10.1186/s12871-024-02781-6","DOIUrl":"10.1186/s12871-024-02781-6","url":null,"abstract":"<p><strong>Background: </strong>To ensure comprehensive dental treatment under general anesthesia(GA) is a viable option, postoperative complications must be minimized. This study investigates the incidence and determinants of acute psychological complications following comprehensive dental treatment under general anesthesia in uncooperative children.</p><p><strong>Materials and methods: </strong>This study included 71 healthy children aged 5 to 10 years who exhibited uncooperative behavior during dental examinations. All participants received parental consent. Data was collected using a checklist encompassing demographic information, treatment details, physical complications, and psychological complications. The Modified Child Dental Anxiety Scale faces version (MCDAS_f) questionnaire was administered pre-operatively and five days post-operatively.</p><p><strong>Results: </strong>The first day exhibited the most pronounced physical and psychological complications. While the most physical complications had diminished by the fifth day, the psychological effects remained permanent. Tooth extraction was associated with a statistically significant impact on fear of being left alone(P < 0.001), unspecified fear (P = 0.001), nyctophobia (P = 0.001), and excessive crying(P < 0.001).</p><p><strong>Conclusion: </strong>Psychological complications persisted for a longer period compared to physical complications. The number of extracted teeth under GA had a significant influence on children's fear.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"393"},"PeriodicalIF":2.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ropivacaine versus ropivacaine plus dexmedetomidine in serratus anterior plane block patients undergoing post-thoracotomy surgery: a randomized, double-blinded clinical trial.","authors":"Mahbobeh Rashidi, Kamran Mahmoodi, Reza Baghbanian, Ahmadreza Mohtadi, Mahdi Selahi","doi":"10.1186/s12871-024-02769-2","DOIUrl":"10.1186/s12871-024-02769-2","url":null,"abstract":"<p><strong>Background: </strong>This study was designed and implemented to investigate the addition of dexmedetomidine to Serratus Anterior Plane Block (SAP) with ropivacaine in reducing pain in patients undergoing post-thoracotomy surgery.</p><p><strong>Methods: </strong>This study included patients classified as American Society of Anesthesiology (ASA) Physical Status II, with a body mass index (BMI) under 40, who were undergoing thoracotomy at Imam Khomeini Hospital in Ahvaz. The subjects were randomly divided into two groups using a randomized controlled trial design. After surgery, in the recovery room, SAP was performed for patients with ropivacaine (0.4 ml/kg of 0.2% ropivacaine solution) (group R) and ropivacaine plus dexmedetomidine (0.5 μg/kg) (group RD). Pain (with verbal rating scale, VNRS), blood pressure (systolic, diastolic, and mean arterial pressure (MAP)), heart rate (HR), and blood oxygen saturation (O2 sat) were measured and recorded before the intervention, and 1, 6, 12, 24, and 48 h after the intervention.</p><p><strong>Results: </strong>Finally, 74 patients were included in this study. Both groups exhibited significant pain reduction at one hour, with sustained pain relief observed in the RD group at 6, 12, and 24 h (P < 0.001). The RD group also showed having lower values HR and MAP at 6 and 12 h (P < 0.001). Patients in the RD group received painkillers faster (P = 0.005) and required lower total narcotic usage (P < 0.0001). Two RD group patients experienced transient bradycardia, which resolved without treatment.</p><p><strong>Conclusion: </strong>The findings of this study show that SAP block with dexmedetomidine is an effective and safe drug along with ropivacaine as a nerve-blocking agent in thoracotomy candidates.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"391"},"PeriodicalIF":2.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy: a prospective, randomized, double-blind controlled clinical trial.","authors":"Lizhu Xiao, Zhenghua Zhang, Jing Lu, Zhaoguo Liu, Jiaoling Zhang, Lu Kang, Jiefu Tang, Xiaohua Zou","doi":"10.1186/s12871-024-02779-0","DOIUrl":"10.1186/s12871-024-02779-0","url":null,"abstract":"<p><strong>Background: </strong>We explored the efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy.</p><p><strong>Methods: </strong>A total of 195 patients who underwent painless colonoscopy surgery were randomly divided into three groups: the propofol deep sedation group (group DS), the sufentanil combined with propofol for conscious sedation (group CS₁) and the esketamine combined with propofol for conscious sedation (group CS₂). The primary outcomes of this study included the incidence of hypoxemia, hypotension, hypertension, and bradycardia and excellent and good rates of anaesthesia during colonoscopy. The secondary outcomes included perioperative changes in vital signs (MAP, HR, and SpO₂), anaesthesia induction time, dischargeable time, patient and endoscopist satisfaction scores, and incidence of postoperative nausea and vomiting (PONV), drowsiness, dizziness, propofol injection pain, assisted ventilation and vasoactive medications.</p><p><strong>Results: </strong>The incidence of intraoperative hypoxemia in the DS group was significantly greater than that in the CS₁ and CS₂ groups (χ2 = 7.081, P = 0.029). The incidence of hypotension in the CS₂ group was significantly lower than that in the DS and CS₁ groups (χ2 = 16.278, P < 0.001). The risk of hypoxemia was 5.727 times higher in Group DS than in Group CS₂ (OR 5.727; 95%CI 1.203-27.273), and the risk of hypotension was 9.864 times higher in Group DS than in Group CS₂ (OR 9.864; 95%CI 2.770-35.120). The risk of hypotension in Group CS₁ was 5.167 times that in Group CS₂ (OR 5.167; 95%CI 1.396-19.117). The incidence of propofol injection pain, assisted ventilation, ephedrine usage and drowsiness in the DS group was significantly greater than that in the CS₁ and CS₂ groups (χ2 = 57.618, P < 0.001; χ2 = 9.544, P = 0.008; χ2 = 14.820, P = 0.001; χ2 = 37.257, P < 0.001). The incidence of dizziness during recovery in the CS₁ group was significantly greater than that in the DS and CS₂ groups (χ2 = 6.594, P = 0.037). The dischargeable time in the DS group was significantly greater than that in the CS₁ and CS₂ groups (F = 53.039, P < 0.001). The satisfaction scores of the endoscopist and patients in the DS group were significantly lower than those in the CS₁ and CS₂ groups (F = 17.390, P < 0.001; F = 19.282; P < 0.001).</p><p><strong>Conclusions: </strong>In conclusion, esketamine combined with propofol for conscious sedation can be safely and effectively used for painless colonoscopy and has fewer complications.It is recommended for painless colonoscopy.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"394"},"PeriodicalIF":2.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}