Safety And Efficacy Of Esketamine And Painless Gastroscopy

Objective Gastroscopy is the most effective method for the diagnosis and treatment of upper gastrointestinal diseases.The main method is to send a soft lens from the oral cavity of the patient to examine the morphological changes of the esophagus,stomach and duodenum in turn.Due to its good diagnostic effect and high specificity, endoscopic treatment can be used when necessary,which is considered as the gold standard of diagnosis.However,pain,nausea,vomiting and body movement often occur during the process.Not conducive to inspection.There is no doubt that there is a great risk in dealing with patients with serious systemic disease.With the continuous development of comfort medicine today,we combine anesthesia with gastroscopy to effectively reduce the occurrence of such cases.It also brings new problems.Propofol has quick onset and good sedative effect,but it also has problems such as respiration,circulation inhibition and pain.Moreover,it has no analgesic effect by itself,and alone use cannot eliminate the pain in the process.Clinical combination with opioids increases the risk of circulatory respiratory depression.At present,under the environment of serious aging society,circulation depression and apnea caused by anesthetic drugs cannot be effectively detected and timely treated in the environment outside the operating room.How to find an effective and safe way of anesthesia is a question we are still exploring.Esketamine,as the right-handed part of ketamine,As an NMDA receptor antagonist,it can produce sedative and analgesic effects without inhibition of circulation and respiration.It can achieve the same level of anesthetic sedation with fewer side effects than ketamine.Therefore,the purpose of this study was to evaluate the safety and efficacy of esketamine in painless gastroenteroscopy.Methods A total of 120 patients aged 18-65 years and regardless of gender who underwent painless gastroscopy in Chaohu Hospital of Anhui Medical University from June 2021 to December 2022 were selected and divided into esketamine group（group S）and control group（group C）by random number table,with 60 patients in each group.Patients in both groups received routine oxygen saturation and blood pressure monitoring after entering the room.Patients in group S were induced by intravenous injection of Esketamine（0.3mg/kg）+propofol（2mg/kg）,and patients in group C were induced by intravenous injection of propofol（2mg/kg）+reifentanil 10ug.After eyelash reflex disappeared,patients were treated with gastroscopy,and0.25mg/kg/h of propofol was used to maintain the depth of anesthesia in both groups.The main outcome measures were blood pressure,heart rate,oxygen saturation,pulse oxygen saturation（Sp O₂）,BIS value,time to recovery of consciousness（the time from last dose to response to call）,and normal walking time（the time from consciousness to normal walking）of the two groups at different time points.Modified Aldrete score,incidence of postoperative adverse reactions.Results There was no significant difference in the general data between the two groups（P>0.05）.The blood pressure,heart rate and oxygen saturation of group S were higher than those of group C at different time periods（P<0.05）;The dosage of propofol in group S was less than that in group C（P<0.05）.The intraoperative body movement in group S was less than that in group C（P<0.05）.Nausea and vomiting were less in group S than in group C（P<0.05）.There was no statistical significance in other observation indexes between 2 groups（P>0.05）.Conclusion The sedation effect of esketamine combined with propofol is better.Propofol consumption and reduction;The dynamics are more stable;Intraoperative body movement,choking cough decreased;The recovery time of consciousness was longer,but the normal walking time was not different.The decrease in oxygen saturation is less and more safe and effective.