A comparative study of dexmedetomidine combined with esketamine and sufentanil for sedation and analgesia in patients undergoing microwave ablation of lung tumors: A prospective single-center randomized double-blind clinical trial.

Background: This study evaluated the efficacy and safety of esketamine plus dexmedetomidine for sedation and analgesia during computed tomography (CT)-guided lung tumor percutaneous microwave ablation (MWA).

Methods: Patients undergoing CT-guided percutaneous MWA of lung tumors were randomly divided into two groups: esketamine plus dexmedetomidine (Group E) and sufentanil plus dexmedetomidine (Group S). The patients' general information, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, respiratory rate (RR), partial pressure of end-tidal carbon dioxide, bispectral index, and Ramsay sedation score were recorded before anesthesia administration (T0), after dexmedetomidine loading dose (T1), during percutaneous puncture (T2), during ablation (T3), at the end of surgery (T4), and during recovery of consciousness (T5). The postoperative Visual Analog Scale (VAS) scores, dexmedetomidine dosage, vasoactive drug usage, instances of sedation failure, and adverse events were also recorded.

Results: Group E showed higher MAP at T5 (P = 0.048) and HR at T3 (P = 0.044) compared to Group S. The RR was significantly higher in Group E than in Group S from T1 to T5 (P < 0.001). The incidence of respiratory depression, bradycardia, and postoperative nausea and vomiting in Group E was lower in Group E than in Group S. No significant differences in Ramsay sedation scores, postoperative VAS scores, dexmedetomidine dosage, vasoactive drug usage, number of sedation failure cases, or occurrence of adverse events were observed between the two groups.

Conclusion: Esketamine plus dexmedetomidine demonstrated potential advantages for lung tumor MWA compared to sufentanil plus dexmedetomidine.