Xiao Huang, Xueyang Li, Yuan Sun, Anshi Wu, Pan Ai
{"title":"艾氯胺酮/异丙酚与舒芬太尼/异丙酚治疗支气管镜术中低氧血症的比较：一项随机试验","authors":"Xiao Huang, Xueyang Li, Yuan Sun, Anshi Wu, Pan Ai","doi":"10.2147/DDDT.S490423","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Propofol and sufentanil are the most commonly used anesthetics during bronchoscopy. Esketamine is an s-enantiomer of ketamine racemate and has both sedative and analgesic effects, it does not inhibit respiration and maintains hemodynamic stability. We aimed to compare the intraoperative hypoxemia risk of esketamine/propofol with sufentanil/propofol for patients in bronchoscopy.</p><p><strong>Methods: </strong>This study was an investigator-initiated, single-center, randomized, double-blind clinical trial. Patients undergoing bronchoscopy were randomly assigned to receive either sufentanil group (n = 33; sufentanil: 0.2 μg/kg) or esketamine group (n = 33; esketamine: 0.2 mg/kg) for sedation and analgesia. Clinical data, anesthetics usage, incidence of intraoperative hypoxemia, total time of hypoxemia, recovery time, and adverse events were recorded.</p><p><strong>Main results: </strong>The incidence of intraoperative hypoxemia was significantly lower in the esketamine group than in the sufentanil group (27.2% vs 66.7%, <i>P</i>=0.001, OR=5.333, 95% CI=1.859-15.301). Propofol usage was significantly higher in the esketamine group than in the sufentanil group (t=2.952, <i>P</i>=0.004). The duration of hypoxia was significantly lower in the esketamine group than in the sufentanil group (Z=-3.445, <i>P</i><0.001), and the minimum oxygen saturation (SpO2) was significantly higher than in the sufentanil group (Z=-2.682, <i>P</i>=0.007). Recovery time from anesthesia was significantly lower in the esketamine group than in the sufentanil group (Z=-2.709, <i>P</i>=0.007). No difference was found in adverse reactions between the two groups.</p><p><strong>Conclusion: </strong>Esketamine combined with propofol reduced the incidence of intraoperative hypoxemia compared with sufentanil in bronchoscopy. Our results offer the possibility for a novel recommendation for the prevention of intraoperative hypoxemia during bronchoscopy. However, we mentioned the higher propofol use in the esketamine group. Additional clarification is necessary on the indications and the optimal dose of esketamine.</p><p><strong>Trial registration: </strong>Chinese clinical trial registry: ChiCTR2200058990.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"4429-4436"},"PeriodicalIF":5.1000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126101/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of Esketamine/Propofol and Sufentanil/Propofol on Intraoperative Hypoxemia During Bronchoscopy: A Randomized Trial.\",\"authors\":\"Xiao Huang, Xueyang Li, Yuan Sun, Anshi Wu, Pan Ai\",\"doi\":\"10.2147/DDDT.S490423\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Propofol and sufentanil are the most commonly used anesthetics during bronchoscopy. Esketamine is an s-enantiomer of ketamine racemate and has both sedative and analgesic effects, it does not inhibit respiration and maintains hemodynamic stability. We aimed to compare the intraoperative hypoxemia risk of esketamine/propofol with sufentanil/propofol for patients in bronchoscopy.</p><p><strong>Methods: </strong>This study was an investigator-initiated, single-center, randomized, double-blind clinical trial. Patients undergoing bronchoscopy were randomly assigned to receive either sufentanil group (n = 33; sufentanil: 0.2 μg/kg) or esketamine group (n = 33; esketamine: 0.2 mg/kg) for sedation and analgesia. Clinical data, anesthetics usage, incidence of intraoperative hypoxemia, total time of hypoxemia, recovery time, and adverse events were recorded.</p><p><strong>Main results: </strong>The incidence of intraoperative hypoxemia was significantly lower in the esketamine group than in the sufentanil group (27.2% vs 66.7%, <i>P</i>=0.001, OR=5.333, 95% CI=1.859-15.301). Propofol usage was significantly higher in the esketamine group than in the sufentanil group (t=2.952, <i>P</i>=0.004). The duration of hypoxia was significantly lower in the esketamine group than in the sufentanil group (Z=-3.445, <i>P</i><0.001), and the minimum oxygen saturation (SpO2) was significantly higher than in the sufentanil group (Z=-2.682, <i>P</i>=0.007). Recovery time from anesthesia was significantly lower in the esketamine group than in the sufentanil group (Z=-2.709, <i>P</i>=0.007). No difference was found in adverse reactions between the two groups.</p><p><strong>Conclusion: </strong>Esketamine combined with propofol reduced the incidence of intraoperative hypoxemia compared with sufentanil in bronchoscopy. Our results offer the possibility for a novel recommendation for the prevention of intraoperative hypoxemia during bronchoscopy. However, we mentioned the higher propofol use in the esketamine group. Additional clarification is necessary on the indications and the optimal dose of esketamine.</p><p><strong>Trial registration: </strong>Chinese clinical trial registry: ChiCTR2200058990.</p>\",\"PeriodicalId\":11290,\"journal\":{\"name\":\"Drug Design, Development and Therapy\",\"volume\":\"19 \",\"pages\":\"4429-4436\"},\"PeriodicalIF\":5.1000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126101/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Drug Design, Development and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/DDDT.S490423\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MEDICINAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug Design, Development and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/DDDT.S490423","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CHEMISTRY, MEDICINAL","Score":null,"Total":0}
Comparison of Esketamine/Propofol and Sufentanil/Propofol on Intraoperative Hypoxemia During Bronchoscopy: A Randomized Trial.
Purpose: Propofol and sufentanil are the most commonly used anesthetics during bronchoscopy. Esketamine is an s-enantiomer of ketamine racemate and has both sedative and analgesic effects, it does not inhibit respiration and maintains hemodynamic stability. We aimed to compare the intraoperative hypoxemia risk of esketamine/propofol with sufentanil/propofol for patients in bronchoscopy.
Methods: This study was an investigator-initiated, single-center, randomized, double-blind clinical trial. Patients undergoing bronchoscopy were randomly assigned to receive either sufentanil group (n = 33; sufentanil: 0.2 μg/kg) or esketamine group (n = 33; esketamine: 0.2 mg/kg) for sedation and analgesia. Clinical data, anesthetics usage, incidence of intraoperative hypoxemia, total time of hypoxemia, recovery time, and adverse events were recorded.
Main results: The incidence of intraoperative hypoxemia was significantly lower in the esketamine group than in the sufentanil group (27.2% vs 66.7%, P=0.001, OR=5.333, 95% CI=1.859-15.301). Propofol usage was significantly higher in the esketamine group than in the sufentanil group (t=2.952, P=0.004). The duration of hypoxia was significantly lower in the esketamine group than in the sufentanil group (Z=-3.445, P<0.001), and the minimum oxygen saturation (SpO2) was significantly higher than in the sufentanil group (Z=-2.682, P=0.007). Recovery time from anesthesia was significantly lower in the esketamine group than in the sufentanil group (Z=-2.709, P=0.007). No difference was found in adverse reactions between the two groups.
Conclusion: Esketamine combined with propofol reduced the incidence of intraoperative hypoxemia compared with sufentanil in bronchoscopy. Our results offer the possibility for a novel recommendation for the prevention of intraoperative hypoxemia during bronchoscopy. However, we mentioned the higher propofol use in the esketamine group. Additional clarification is necessary on the indications and the optimal dose of esketamine.
Trial registration: Chinese clinical trial registry: ChiCTR2200058990.
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.
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Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development
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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.
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