Department of Anesthesiology, Pain and Perioperative Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Drug Des Devel Ther. 2024 May 23;18:1727-1741. doi: 10.2147/DDDT.S457625. eCollection 2024.
To investigate and quantify the effect of continuous esketamine infusion at different doses on the bispectral index (BIS) during sevoflurane anesthesia.
A total of 120 patients scheduled for elective laparoscopic renal surgery were randomly divided into three groups. Under steady anesthesia and surgical situations, the patient was started on continuous infusion of the study drug: 0.125 mg/kg/h esketamine (group E1), 0.25 mg/kg/h esketamine (group E2), and the same volume of saline (group C). The primary outcome was changes in BIS value after 15 min (T), 30 min (T), 45 min (T), and 60 min (T) of drug infusion. The secondary outcomes were 95% spectral edge frequency (SEF95), electromyogram (EMG), heart rate (HR), and mean arterial pressure (MAP) from T to T. Furthermore, postoperative pain, postoperative recovery, and perioperative adverse events were evaluated.
Compared with group C, group E1 exhibited significant BIS elevation at T-T and group E2 at T-T ( < 0.001). Compared with group E1, group E2 showed a more significant BIS elevation at T-T ( < 0.001). The area under the curve (AUC) of BIS and SEF95 were significantly higher in group E2 than in groups C and E1 ( < 0.05). BIS value for any of the three groups was significantly correlated with SEF95 ( < 0.001). No significant differences were observed in the AUC of EMG, HR, and MAP among the three groups. Intraoperative remifentanil consumption and postoperative NRS of pain on movement were significantly reduced in group E2 compared with groups C and E1 ( < 0.05).
Continuous infusion of both 0.125 and 0.25 mg/kg/h of esketamine increased the BIS value during sevoflurane anesthesia, and the BIS value gradually stabilized with the prolongation of the infusion time.
研究并量化不同剂量持续输注氯胺酮对七氟醚麻醉时脑电双频指数（BIS）的影响。
选择拟行择期腹腔镜肾手术的患者 120 例，随机均分为 3 组。在稳定的麻醉和手术条件下，开始给予患者研究药物的持续输注：0.125 mg/kg/h 氯胺酮（E1 组）、0.25 mg/kg/h 氯胺酮（E2 组）和相同容量的生理盐水（C 组）。主要结局是药物输注后 15 min（T1）、30 min（T2）、45 min（T3）和 60 min（T4）时 BIS 值的变化。次要结局为 T1 至 T4 时的 95%光谱边缘频率（SEF95）、肌电图（EMG）、心率（HR）和平均动脉压（MAP）。此外，评估术后疼痛、术后恢复和围术期不良事件。
与 C 组相比，E1 组在 T1-T4 时 BIS 升高，E2 组在 T1-T4 时 BIS 升高（均<0.001）。与 E1 组相比，E2 组在 T1-T4 时 BIS 升高更明显（均<0.001）。E2 组 BIS 和 SEF95 的曲线下面积（AUC）明显高于 C 组和 E1 组（均<0.05）。三组 BIS 值均与 SEF95 显著相关（均<0.001）。三组的 EMG、HR 和 MAP 的 AUC 无显著差异。与 C 组和 E1 组相比，E2 组术中瑞芬太尼的消耗量和术后运动时的 NRS 疼痛评分显著降低（均<0.05）。
持续输注 0.125 和 0.25 mg/kg/h 的氯胺酮均能增加七氟醚麻醉时的 BIS 值，且随着输注时间的延长，BIS 值逐渐稳定。
