The Impact of Esketamine Combined with Dexmedetomidine on Laparoscopic Gallbladder Surgery: A Randomized Controlled Trial.

Objective: To assess the efficacy of combining esketamine with dexmedetomidine in laparoscopic gallbladder surgery. Methods: We investigated 110 laparoscopic cholecystectomy patients at Jinan Central Hospital, affiliated with Shandong First Medical University, from April 2019 to March 2020. Patients were randomly assigned to the control group (n = 55) or observation group (n = 55). The control group received dexmedetomidine intravenously at 1 µg/kg and a continuous infusion at 0.5 µg•kg-1•h-1. The observation group received esketamine and dexmedetomidine, with intravenous esketamine at 0.4 mg/kg and a continuous infusion at 0.1 mg/(kg•h). We measured heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) at four-time points: before anesthesia (T0), 30 minutes after anesthesia (T1), extubation (T2), and awakening (T3). We also assessed wake time, post-anesthesia care unit (PACU) stay, and Ramasy and visual analogue scale (VAS) scores at 2, 6, 12, and 24 hours post-surgery. Results: At T0, no significant changes occurred in HR, SBP, and DBP in both groups (P > .05). However, at T1 and T2, HR, SBP, and DBP gradually decreased, with the control group exhibiting lower levels than the observation group (P < .05). These levels returned to baseline at T3. PACU residence and wake times showed no significant differences (P > .05). At 2 hours post-operation, Ramasy scores significantly dropped in the observation group versus the control group (P < .05). At 6, 12, and 24 hours post-operation, Ramasy scores exhibited no significant differences (P > .05). Moreover, at 2, 6, and 12 hours post-operation, VAS scores in the observation group were notably lower than in the control group (P < .05). At 24 hours post-operation, VAS scores revealed no significant differences (P > .05). Adverse reactions within 3 days post-operation did not differ significantly between the groups (P > .05). Conclusions: Combining esketamine with dexmedetomidine enhances the quality of laparoscopic cholecystectomy, alleviates postoperative agitation, accelerates cognitive function recovery, reduces cognitive function impairment, and merits clinical consideration.

Study on the combination of remazolam besylate and sufentanil in elderly patients with percutaneous vertebroplasty.

This study analyzed the application effect of remimazolam besylate combined with sufentanil on percutaneous vertebroplasty (PVP). Forty elderly patients with osteoporotic vertebral compression fractures (OVCF) were randomly divided into sufentanil (A group) and remimazolam besylate + sufentanil groups (B group). A group was given sufentanil anesthesia, B group was given remimazolam besylate combined with sufentanil anesthesia. Heart rate (HR), mean arterial pressure (MAP), saturation of pulse oxygen (SpO2) and Ramsay sedation score were recorded at different time points, including T0 (before administration), T1 (beginning of surgery), T2 (perfusion of bone cement) and T3 (end of surgery). HR, MAP, SpO2 were continuously monitored by electrocardiogram monitor. The visual analogue scale (VAS) pain scores of the two groups were recorded at before anesthesia and immediately after surgery. The adverse reactions (AR) were observed, including respiratory depression, nausea and vomiting, and restlessness during the recovery period. Compared with group A, MAP was increased at T2 and T3 time points in group B. Ramsay sedation scores at T2 time points in group B were higher than that in group A. The VAS score of immediately after operation and incidence of AR of group B was lower than that of group A. In elderly patients undergoing PVP, remimazolam besylate combined with sufentanil has no obvious effect on patients' respiratory parameters, with clear analgesic and sedative effects and low incidence of AR, which is worthy of promotion.