Application Of Different Doses Of Esketamine Compounded With Propofol In Hysteroscopy

Objective:To compare the anesthetic effects of different doses of esketamine combined with propofol in hysteroscopy,and to explore the optimal induction dose of esketamine.Methods:90 patients underwent elective painless hysteroscopy,aged 20-55 years,body mass index 19k-30kg/m2,ASA Ⅰ ～ Ⅱ class.The patients were randomly divided into three groups(n=30),esketamine induction dose0.5mg/kg group(S group),esketamine induction dose 0.4mg/kg group(E1group)and esketamine induction dose 0.3mg/kg kg group(E2 group).All patients were treated with 1.5 mg/kg propofol during induction,and 0.5-1mg/kg of propofol was added if there was movement during the operation.The systolic blood pressure(Systolic blood pressure,SBP),Diastolic blood pressure(Diastolic blood pressure,DBP),heart rate(Heart Rate,HR);observe and record the respiratory rate of the patient 5 minutes after entering the room and after induction of anesthesia,and the occurrence of intraoperative hypoxemia(Sp O2<90%);The frequency and dose of phenol supplementation and the incidence of injection pain;the patient’s wake-up time,the pain degree(Numeric Rating Scale,NRS)at 5 minutes and 24 hours after waking up;and whether there is restlessness and tearing after waking up.Results:There was no significant difference in the general conditions of the three groups of patients(P>0.05);compared with the E2 group,the systolic blood pressure of the E1 group and the S group was more stable(P<0.05);compared with the S group,the E1 group and the E2 group The diastolic blood pressure was more stable(P<0.05);there was no significant difference in heart rate changes among the three groups(P>0.05);there were no significant differences in the respiratory rate and the occurrence of hypoxemia among the three groups after induction(P>0.05);Compared with group E2,group S and group E1 had significantly lower propofol injection pain(P<0.05);there was no significant difference in recovery time and NRS score among the three groups(P>0.05);Compared with group S,he proportion of restlessness and tears in group E1 and E2 was significantly lower(P<0.05).Conclusions:Compared with the induction dose of 0.5mg/kg and 0.3mg/kg,the induction dose of esketamine can not only ensure the relatively stable hemodynamics in the operation,but also reduce the additional dose of propofol in the operation and the incidence of injection pain;it does not affect the patient’s induced respiratory rate,does not increase the incidence of intraoperative hypoxemia;does not affect the patient’s recovery time;does not increase the incidence of postoperative pain;at the same time reduces postoperative restlessness and tearing incidence rate.