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Original Research

Open Access

Efficacy and safety of propofol in combination with different esketamine doses for anesthesia during loop electrosurgical excision procedure

  • Qian Wu1
  • Yonggang Hao1,*,
  • Shanqiu Wang1

1Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China

DOI: 10.22514/sv.2024.126 Vol.20,Issue 10,October 2024 pp.56-61

Submitted: 26 February 2024 Accepted: 06 May 2024

Published: 08 October 2024

*Corresponding Author(s): Yonggang Hao E-mail: hyg203385@hospital-cqmu.com

Abstract

To investigate the efficacy and safety of propofol combined with different doses of esketamine (ESK) for anesthesia during loop electrosurgical excision procedure (LEEP). Ninety female patients undergoing LEEP were randomly allocated to three groups: group P (2 mg/kg propofol + saline), group propofol + esketamine (PK)1 (1.5 mg/kg propofol+ 0.5 mg/kg ESK), and group PK2 (1.5 mg/kg propofol + 0.25 mg/kg ESK). Parameters including mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), oxygen saturation (SPO2), and venous carbon dioxide (PvCO2) were recorded. Additionally, the need for supplemental propofol, jaw thrust maneuver or ventilation, postoperative awakening time, and adverse reactions were assessed. After induction, there was a significant decrease in MAP and HR observed in group P, while an increase was noted in group PK1 (both p < 0.05), with no notable change in group PK2 (p > 0.05). By the 5-minute mark post-induction, group PK1 exhibited RR and PvCO2 levels similar to pre-induction levels (p > 0.05), whereas group PK2 demonstrated an increase in RR and a decrease in PvCO2 (p < 0.05). The occurrence of jaw thrust maneuvers in group PK1 and group P was higher than in group PK2 (p < 0.05). Moreover, fewer patients necessitated additional intraoperative propofol in groups PK1 and PK2 compared to group P (p < 0.05). The time to awakening was shorter in group PK2 than in groups PK1 and P (p < 0.05). Additionally, the frequency of postoperative vertigo was higher in group PK1 compared to groups P and PK2 (p < 0.05), the incidence of nausea did not significantly differ among the three groups (p > 0.05). Notably, neither irritation nor delirium was reported in any of the three groups. This study suggested that propofol combined with low-dose esketamine characterized minimal disruption to circulatory and respiratory parameters, reduced occurrences of adverse reactions, and faster postoperative awakening.


Keywords

Esketamine; LEEP; Propofol


Cite and Share

Qian Wu,Yonggang Hao,Shanqiu Wang. Efficacy and safety of propofol in combination with different esketamine doses for anesthesia during loop electrosurgical excision procedure. Signa Vitae. 2024. 20(10);56-61.

References

[1] Ramírez SI, Lutzkanin A. Management of cervical dysplasia using office loop electrosurgical excision procedure. Primary Care. 2021; 48: 583–595.

[2] Limwatanapan N, Chalapati W, Songthamwat S, Saenpoch S, Buapaichit K, Songthamwat M. Lidocaine spray versus paracervical block during loop electrosurgical excision procedure: a randomized trial. Journal of Lower Genital Tract Disease. 2018; 22: 38–41.

[3] Yan T, Zhang GH, Wang BN, Sun L, Zheng H. Effects of propofol/remifentanil-based total intravenous anesthesia versus sevoflurane-based inhalational anesthesia on the release of VEGF-C and TGF-β and prognosis after breast cancer surgery: a prospective, randomized and controlled study. BMC Anesthesiology. 2018; 18: 131.

[4] Song N, Yang Y, Zheng Z, Shi W, Tan A, Shan X, et al. Effect of esketamine added to propofol sedation on desaturation and hypotension in bidirectional endoscopy. JAMA Network Open. 2023; 6: e2347886.

[5] Oh C, Kim Y, Eom H, Youn S, Lee S, Ko YB, et al. Procedural sedation using a propofol-ketamine combination (Ketofol) vs. propofol alone in the loop electrosurgical excision procedure (LEEP): a randomized controlled trial. Journal of Clinical Medicine. 2019; 8: 943.

[6] Liu Z, Zou X, Sun X, Fan W. Loop electrosurgical excision procedure under propofol intravenous anesthesia combined with nano-silver gel in the treatment of cervicitis. Cellular and Molecular Biology. 2022; 68: 96–104.

[7] Eberl S, Koers L, van Hooft J, de Jong E, Hermanides J, Hollmann MW, et al. The effectiveness of a low-dose esketamine versus an alfentanil adjunct to propofol sedation during endoscopic retrograde cholangiopancreatography: a randomised controlled multicentre trial. European Journal of Anaesthesiology. 2020; 37: 394–401.

[8] Li H, Wu H, Peng J. Evaluation of low-dose esketamine on sleep quality in elderly patients undergoing painless gastroscopy. Tropical Journal of Pharmaceutical Research. 2023; 22: 887–891.

[9] Jia T, Teng J. New narcotic analgesics: esketamine. Chinese Journal of Clinical Pharmacology and Therapeutics. 2022; 27: 834–840.

[10] Yang H, Zhao Q, Chen H, Liu W, Ding T, Yang B, et al. The median effective concentration of propofol with different doses of esketamine during gastrointestinal endoscopy in elderly patients: a randomized controlled trial. British Journal of Clinical Pharmacology. 2022; 88: 1279–1287.

[11] Chen H, Ding X, Xiang G, Xu L, Liu Q, Fu Q, et al. Analysis of the efficacy of subclinical doses of esketamine in combination with propofol in non-intubated general anesthesia procedures—a systematic review and meta-analysis. BMC Anesthesiology. 2023; 23: 245.

[12] Lu C, Ren J, Guo X, Qian J. Effects of remimazolam combined with esketamine anesthesia on circulatory and respiratory function during painless gastroenteroscopy. Contrast Media & Molecular Imaging. 2022; 2022: 1079099.

[13] Nie J, Chen W, Jia Y, Zhang Y, Wang H. Comparison of remifentanil and esketamine in combination with propofol for patient sedation during fiberoptic bronchoscopy. BMC Pulmonary Medicine. 2023; 23: 254.

[14] Jonkman K, van Rijnsoever E, Olofsen E, Aarts L, Sarton E, van Velzen M, et al. Esketamine counters opioid-induced respiratory depression. British Journal of Anaesthesia. 2018; 120: 1117–1127.

[15] Eberl S, Koers L, van Hooft JE, de Jong E, Schneider T, Hollmann MW, et al. Sedation with propofol during ERCP: is the combination with esketamine more effective and safer than with alfentanil? Study protocol for a randomized controlled trial. Trials. 2017; 18: 472.

[16] Trujillo KA, Heller CY. Ketamine sensitization: influence of dose, environment, social isolation and treatment interval. Behavioural Brain Research. 2020; 378: 112271.


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