Xin yixue (May 2024)

Esketamine combined with dexmedetomidine and lidocaine induced inbition of tracheal intubation response

  • DENG Dongxiang, WU Duozhi

DOI
https://doi.org/10.3969/j.issn.0253-9802.2024.05.003
Journal volume & issue
Vol. 55, no. 5
pp. 335 – 341

Abstract

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Objective To investigate the median effective dose (ED50) of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine under opioid-free anesthesia (OFA). Methods Adult patients aged 18-59 years with body mass index (BMI)<30 kg/m² and ASA grade Ⅰ or Ⅱ were selected for endotracheal intubation general anesthesia. Dixon sequential method was adopted. The initial dose of esketamine was 0.5 mg/kg, and the dose of the next patient was determined according to the tracheal intubation response. The ratio of adjacent doses was 1:1.1. The ED50 and 95% confidence interval (CI) of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine OFA were calculated. Results A total of 29 patients were included for statistical analysis. Tracheal intubation reaction was positive in 15 cases (positive group) and negative in 14 cases (negative group). In the positive group, 3 cases had cough reaction during tracheal intubation. The ED50 of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine OFA was 0.448 mg/kg, and the corresponding 95%CI was 0.421-0.476 mg/kg. Conclusion In the OFA of esketamine combined with dexmedetomidine and lidocaine, 0.448 mg/kg of esketamine results in 50% of the maximum response intensity for inhibiting tracheal intubation response.

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