Safety and tolerability of esketamine in propofol based sedation for endoscopic variceal ligation with or without injection sclerotherapy: Randomized controlled trial

作者全名："Chen, Yuanjing; Chen, Jie; Wang, Quankai; Lyu, Hongyao; Chen, Xuehan; Liu, Rui; Wang, Ting; Dan, Ling; Huang, He; Duan, Guangyou"

作者地址："[Chen, Yuanjing; Chen, Jie; Wang, Quankai; Chen, Xuehan; Liu, Rui; Dan, Ling; Huang, He; Duan, Guangyou] Chongqing Med Univ, Affiliated Hosp 2, Dept Anesthesiol, 288 Tianwen Ave, Chongqing 400061, Peoples R China; [Wang, Ting] Chongqing Med Univ, Affiliated Hosp 2, Dept Psychol, Chongqing, Peoples R China; [Lyu, Hongyao] Sichuan Univ, West China Sch Publ Hlth, Dept Prevent Med, Chengdu, Peoples R China"

通信作者："Duan, GY (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Anesthesiol, 288 Tianwen Ave, Chongqing 400061, Peoples R China."

来源：DIGESTIVE ENDOSCOPY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000955054500001

JCR分区：Q1

影响因子：5

年份：2023

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期号：　

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结束页：　

文献类型：Article; Early Access

关键词：endoscopic variceal ligation; esketamine; liver cirrhosis; propofol; sedation

摘要："ObjectivesEsketamine is an S (+) enantiomer of ketamine with greater potency and similar psychomimetic effects compared to racemic ketamine. We aimed to explore the safety of esketamine in different doses as an adjuvant to propofol in patients undergoing endoscopic variceal ligation (EVL) with or without injection sclerotherapy. MethodsOne hundred patients were randomized to receive sedation with propofol 1.5 mg/kg in combination with sufentanil 0.1 mu g/kg (group S), esketamine 0.2 mg/kg (group E0.2), esketamine 0.3 mg/kg (group E0.3), or esketamine 0.4 mg/kg (group E0.4) for EVL (n = 25 each). Hemodynamic and respiratory parameters were recorded during the procedure. The primary outcome was the incidence of hypotension; secondary outcomes included the incidence of desaturation, positive and negative syndrome scale (PANSS) after the procedure, pain score after the procedure, and secretion volume. ResultsThe incidence of hypotension was significantly lower in groups E0.2 (36%), E0.3 (20%), and E0.4 (24%) than in group S (72%). The incidence of SpO(2) <= 94% was significantly lower in group E0.4 (4%) than in group S (32%). No significant intergroup difference was found in the PANSS assessment. ConclusionsCombining 0.4 mg/kg esketamine with propofol sedation was optimal to facilitate EVL with stable hemodynamic status and better respiratory function during the procedure, without significant psychomimetic side-effects. Trial registrationChinese Clinical Trial Registry (Trial ID: ChiCTR2100047033, )."

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