Effect Of Low Dose Esketamine On Cough Response To Tracheal Tube During Extubation After Thyroidectomy

Objective:Severe coughing during tracheal extubation after thyroidectomy may cause postoperative bleeding,which can endanger life.We aimed to investigate the effect of low dose esketamine on cough response during tracheal extubation in patients undergoing thyroidectomy.Methods:66 patients,21 males and 45 females,aged 18～65 years,with BMI 18～25kg/m~2,ASAⅠ～Ⅱ,for selective thyroidectomy under intravenous general anesthesia with endotracheal intubation,were randomly divided into two groups:esketamine group（n=33）and control group（n=33）.At 30 min before the end of operation,esketamine group was injected 0.25mg/kg esketamine intravenously,and control group was administered by intravenous injection with constant volumes saline 0.9%.Recorded the incidence and intensity of cough during tracheal extubation.Recorded the mean arterial pressure（MAP）and heart rate（HR）at pre-induction of anesthesia（T₁）,at five minutes after intravenous administration（T₂）,at immediate extubation time（T₃）and five minutes after extubation time（T₄）.The patients’anesthesia recovery profiles:eye-opening time and extubation time,hemodynamic changes during extubation and volume of drainage on postoperative Day 1 and postoperative Day 2 were recorded.Observed the adverse effects including nightmare,illusion and optic ambiguity.Results:The incidence and intensity of cough during tracheal extubation were lower in esketamine group than that in control group（P<0.05）.Compared with the control group,the mean arterial time（MAP）and heart rate（HR）were increased significantly at T₂（P<0.05）,and that decreased significantly at T_3-4in esketamine group（P<0.05）.Eye-opening time and extubation time had no statistical significance in the two groups（P>0.05）.The drainage’volume on postoperative Day 1 and postoperative Day 2 in esketamine group were distinctly less than that in control group（P<0.05）.There were no adverse effects including nightmare,illusion and optic ambiguity in the two groups.Conclusion:Low dose of esketamine can significantly reduce the incidence of cough during tracheal extubation and postoperative blood loss in patients for thyroidectomy,and have no adverse effects during emergence from anesthesia.