Efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy: a prospective, randomized, double-blind controlled clinical trial.
Humans
Propofol
/ administration & dosage
Double-Blind Method
Male
Female
Ketamine
/ administration & dosage
Middle Aged
Prospective Studies
Conscious Sedation
/ methods
Colonoscopy
/ methods
Adult
Hypnotics and Sedatives
/ administration & dosage
Sufentanil
/ administration & dosage
Postoperative Nausea and Vomiting
/ epidemiology
Drug Therapy, Combination
Aged
Conscious sedation
Deep sedation
Efficacy
Esketamine
Painless colonoscopy
Safety
Journal
BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535
Informations de publication
Date de publication:
30 Oct 2024
30 Oct 2024
Historique:
received:
24
07
2024
accepted:
22
10
2024
medline:
31
10
2024
pubmed:
31
10
2024
entrez:
31
10
2024
Statut:
epublish
Résumé
We explored the efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy. A total of 195 patients who underwent painless colonoscopy surgery were randomly divided into three groups: the propofol deep sedation group (group DS), the sufentanil combined with propofol for conscious sedation (group CS The incidence of intraoperative hypoxemia in the DS group was significantly greater than that in the CS In conclusion, esketamine combined with propofol for conscious sedation can be safely and effectively used for painless colonoscopy and has fewer complications.It is recommended for painless colonoscopy.
Sections du résumé
BACKGROUND
BACKGROUND
We explored the efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy.
METHODS
METHODS
A total of 195 patients who underwent painless colonoscopy surgery were randomly divided into three groups: the propofol deep sedation group (group DS), the sufentanil combined with propofol for conscious sedation (group CS
RESULTS
RESULTS
The incidence of intraoperative hypoxemia in the DS group was significantly greater than that in the CS
CONCLUSIONS
CONCLUSIONS
In conclusion, esketamine combined with propofol for conscious sedation can be safely and effectively used for painless colonoscopy and has fewer complications.It is recommended for painless colonoscopy.
Identifiants
pubmed: 39478485
doi: 10.1186/s12871-024-02779-0
pii: 10.1186/s12871-024-02779-0
doi:
Substances chimiques
Propofol
YI7VU623SF
Ketamine
690G0D6V8H
Esketamine
50LFG02TXD
Hypnotics and Sedatives
0
Sufentanil
AFE2YW0IIZ
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
394Subventions
Organisme : Department of Science and Technology of Hunan Province,China
ID : 2021SK4047
Organisme : Department Science and Technology of Huaihua,China
ID : 2022R2203
Informations de copyright
© 2024. The Author(s).
Références
Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, Znaor A, Bray F. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
doi: 10.3322/caac.21492
pubmed: 30207593
Sun DJ, You YX, He XJ, Li HT, Zeng XP, Li DZ, Wang W. Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: a randomized controlled trial. Med (Baltim). 2022;101(52):e32339.
doi: 10.1097/MD.0000000000032339
Shi CM, Zhou Y, Yang N, Li ZQ, Tao YF, Deng Y, Guo XY. Quality of psychomotility recovery after propofol sedation for painless gastroscopy and colonoscopy. Beijing Da Xue Xue Bao Yi Xue Ban. 2023;55(2):324–7.
pubmed: 37042144
Kang S, Lu J, Zhou HM. Anesthetic strategy for obese patients during gastroscopy: deep sedation or conscious sedation? A prospective randomized controlled trial. J Anesth. 2021;35(4):555–62.
doi: 10.1007/s00540-021-02951-7
pubmed: 34052943
Stefanutto TB, Feiner J, Krombach J, Brown R, Caldwell JE. Hemoglobin desaturation after propofol/remifentanil-induced apnea: a study of the recovery of spontaneous ventilation in healthy volunteers. Anesth Analgesia. 2012;114(5):980–6.
doi: 10.1213/ANE.0b013e31824e5bc4
Wang ZC, Liu JF, Lei YQ, Xu N, Huang ST, Chen LW, Cao H, Chen Q. Midazolam for conscious sedation in transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography. Cardiol Young. 2022;32(2):282–6.
doi: 10.1017/S104795112100202X
pubmed: 34024301
Wang X, Zhang M, Sun H, Zhang R, Zhu Y, Zhang Z, Shi R. Dexmedetomidine-oxycodone combination for conscious sedation during colonoscopy in obese patients: a randomized controlled trial. Heliyon. 2023;9(5):e16370.
doi: 10.1016/j.heliyon.2023.e16370
pubmed: 37251861
Gao L, Zhang Z, Zhu Y, Lu X, Tian Y, Wei L. Effect of pretreatment with a small dose of esketamine on sufentanil-induced cough during anesthesia induction: a randomized controlled trial. BMC Anesthesiol. 2024;24(1):116–21.
doi: 10.1186/s12871-024-02501-0
pubmed: 38528479
Zhao L, Li Z, Jin B, Hou N, Yang H. Safety and efficacy of low-dose esketamine in laparoscopic cholecystectomy: a prospective, double-blind randomized controlled trial. BMC Anesthesiol. 2024;24(1):47–58.
doi: 10.1186/s12871-024-02429-5
pubmed: 38302944
Ma Y, Wang J, Yang Y, Yao M. Efficacy and safety of esketamine combined with propofol for curative endoscopic resection in colorectum: a prospective, randomized controlled trial. BMC Anesthesiol. 2024;24(1):96–103.
doi: 10.1186/s12871-024-02475-z
pubmed: 38459471
pmcid: 10924399
Deng J, Yu YF, Tang ZG, Lei HJ, Tan CC. Efficacy and safety of low-dose esketamine for painless gastrointestinal endoscopy in adults: a systematic evaluation and meta-analysis. Front Pharmacol. 2024;15:1364546.
doi: 10.3389/fphar.2024.1364546
pubmed: 38645560
pmcid: 11026590
Xin N, Yan W, Jin S. Efficacy of analgesic propofol/esketamine and propofol/fentanyl for painless induced abortion: a randomized clinical trial. Biomed Res Int. 2022, 2022: 5095282.
Huang X, Ai P, Wei C, Sun Y, Wu A. Comparison of the effects of esketamine/propofol and sufentanil/propofol on the incidence of intraoperative hypoxemia during bronchoscopy: protocol for a randomized, prospective, parallel-group Trial. J Clin Med. 2022;11(15):4587–96.
doi: 10.3390/jcm11154587
pubmed: 35956202
pmcid: 9369459
Jonkman K, van Rijnsoever E, Olofsen E, Aarts L, Sarton E, Van Velzen M, Niesters M, Dahan A. Jonkman K,Van Rijnsoever E,Olofsen E. Esketamine counters opioid-induced respiratory depression. Br J Anaesth. 2018;120(5):1117–27.
doi: 10.1016/j.bja.2018.02.021
pubmed: 29661389
Kamp J, van Velzen M, Aarts L, Niesters M, Dahan A, Olofsen E. Stereoselective ketamine effect on cardiac output: a population pharmacokinetic/pharmacodynamic modelling study in healthy volunteers. Br J Anaesth. 2021;127(1):23–31.
doi: 10.1016/j.bja.2021.02.034
pubmed: 33896589
pmcid: 8258972
Song N, Shan XS, Yang Y, Zheng Z, Shi WC, Yang XY, Li Y, Tan AP, Liu H, Peng K, Ji FH. Low-dose esketamine as an adjuvant to propofol sedation for same-visit bidirectional endoscopy: protocol for a multicenter randomized controlled trial. Int J Gen Med. 2022;15:4733–40.
doi: 10.2147/IJGM.S365068
pubmed: 35571286
pmcid: 9091685
Yin S, Hong J, Sha T, Chen Z, Guo Y, Li C, Liu Y. Efficacy and tolerability of sufentanil, dexmedetomidine, or ketamine added to propofol-based sedation for gastrointestinal endoscopy in elderly patients: a prospective, randomized, controlled Trial. Clin Ther. 2019;41(9):1864–77.
doi: 10.1016/j.clinthera.2019.06.011
pubmed: 31345559
Rotroff DM, Corum DG, Motsinger-Reif A, Fiehn O, Bottrel N, Drevets WC, Singh J, Salvadore G, Kaddurah-Daouk R. Metabolomic signatures of drug response phenotypes for ketamine and esketamine in subjects with refractory major depressive disorder: new mechanistic insights for rapid acting antidepressants. Transl Psychiatry. 2016;6(9):e894.
doi: 10.1038/tp.2016.145
pubmed: 27648916
pmcid: 5048196
Eberl S, Koers L, Van Hooft J, de Jong E, Hermanides J, Hollmann MW, Preckel B. The effectiveness of a low-dose esketamine versus an alfentanil adjunct to propofol sedation during endoscopic retrograde cholangiopancreatography: a randomised controlled multicentre trial. Eur J Anaesthesiol. 2020;37(5):394–401.
doi: 10.1097/EJA.0000000000001134
pubmed: 31860599
Sigtermans M, Dahan A, Mooren R, Bauer M, Kest B, Sarton E, Olofsen E. S(+)-ketamine effect on experimental pain and cardiac output: a population pharmacokinetic-pharmacodynamic modeling study in healthy volunteers. Anesthesiology. 2009;111(4):892–903.
doi: 10.1097/ALN.0b013e3181b437b1
pubmed: 19741495
Daly EJ, Singh JB, Fedgchin M, Cooper K, Lim P, Shelton RC, Thase ME, Winokur A, Van Nueten L, Manji H, Drevets WC. Efficacy and safety of intranasal esketamine adjunctive to oral antidepressant therapy in treatment-resistant depression: a randomized clinical trial. JAMA Psychiatry. 2018;75(2):139–48.
doi: 10.1001/jamapsychiatry.2017.3739
pubmed: 29282469
Srinivasan SS, Alshareef A, Hwang A, Byrne C, Kuosmanen J, Ishida K, Jenkins J, Liu S, Madani WAM, Hayward AM, Fabian N, Traverso G. A vibrating ingestible bioelectronic stimulator modulates gastric stretch receptors for illusory satiety. Sci Adv. 2023;9(51):eadj3003.
doi: 10.1126/sciadv.adj3003
pubmed: 38134286
Wang J, Huang J, Yang S, Cui C, Ye L, Wang SY, Yang GP, Pei Q. Pharmacokinetics and safety of esketamine in Chinese patients undergoing painless gastroscopy in comparison with ketamine: a randomized, open-label clinical study. Drug Des Devel Ther. 2019;13:4135–44.
doi: 10.2147/DDDT.S224553
pubmed: 31827320
Su Y, Zhang J, Wang H, Gu Y, Ouyang H, Huang W. The use of esketamine in CT-guided percutaneous liver tumor ablation reduces the consumption of remifentanil: a randomized, controlled, double-blind trial. Ann Transl Med. 2022;10(12):704–14.
doi: 10.21037/atm-22-2756
pubmed: 35845514
Zhang C, He J, Shi Q, Bao F, Xu J. Subanaesthetic dose of esketamine during induction delays anaesthesia recovery a randomized, double-blind clinical trial. BMC Anesthesiol. 2022;22(1):138–43.
doi: 10.1186/s12871-022-01662-0
pubmed: 35534825
Zhan Y, Liang S, Yang Z, Luo Q, Li S, Li J, Liang Z, Li Y. Efficacy and safety of subanesthetic doses of esketamine combined with propofol in painless gastrointestinal endoscopy: a prospective, double-blind, randomized controlled trial. BMC Gastroenterol. 2022;22(1):391–9.
doi: 10.1186/s12876-022-02467-8
pubmed: 35987996
Feng Y, Du T, Wang J, Chen Z, Wang Jafang, et al. Low dose of esketamine combined with propofol in painless fibronchoscopy in elderly patients. Med (Baltim). 2022;101(50):e31572.
doi: 10.1097/MD.0000000000031572
Ionescu DF, Fu DJ, Qiu X, Lane R, Lim P, Kasper S, Hough D, Drevets WC, Manji H, Canuso CM. Esketamine nasal spray for rapid reduction of depressive symptoms in patients with major depressive disorder who have active suicide ideation with intent: results of a phase 3, double-blind, randomized study (ASPIRE II). Int J Neuropsychopharmacol. 2021;24(1):22–31.
doi: 10.1093/ijnp/pyaa068
pubmed: 32861217
Popova V, Daly EJ, Trivedi M, Cooper K, Lane R, Lim P, Mazzucco C, Hough D, Thase ME, Shelton RC, Molero P, Vieta E, Bajbouj M, Manji H, Drevets WC, Singh JB. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: a randomized double-blind active-controlled study. Am J Psychiatry. 2019;176(6):428–38.
doi: 10.1176/appi.ajp.2019.19020172
pubmed: 31109201
Walsh CT, Walsh Christopher T, Propofol. Milk of Amnesia. Cell. 2018;175(1):10–3.
doi: 10.1016/j.cell.2018.08.031
pubmed: 30217361
Wu Q, Xu F, Wang J, Jiang M. Efficacy and Safety of Ketamine Compared with placebo and other medications for preventing Propofol Injection Pain in adults: a systematic review and Meta-analysis. J Pain Res. 2024;17:459–76.
doi: 10.2147/JPR.S440250
pubmed: 38318331
pmcid: 10843985
Fu D, Wang D, Li W, Han Y, Jia J. Pretreatment with low-dose esketamine for reduction of propofol injection pain: a randomized controlled trial. Pain Res Manag. 2022;2022:4289905.
doi: 10.1155/2022/4289905
pubmed: 35958679
pmcid: 9363235
Ueki R, Tanimoto M, Tatara T, Tsujimoto S, Kaminoh Y, Tashiro C. Emulsion of flurbiprofen axetil reduces propofol injection pain due to a decrease in free propofol concentration. J Anesth. 2007;21(3):325–33.
doi: 10.1007/s00540-007-0530-1
pubmed: 17680183
Su M, Chen T, Zhong Q, Lin D, Liu W, Su Y, Deng J, Zhang J, Hu J, Guo X. Choice of injection time of conscious sedation and its impact on pain control in colonoscopy. Front Surg. 2022;9:886129.
doi: 10.3389/fsurg.2022.886129
pubmed: 36329974
pmcid: 9622756