The effects of etomidate combined with remifentanil on postoperative pain and recovery quality in patients under-going nasal sinus surgery
ZHENG Shao-qing
CHEN Xiao-shu
DENG Yu-ping
HUANG Huan-sen
Abstract：Objective To investigate the effects of etomidate combined with anesthesia induction on postoperative pain and recovery quality in patients undergoing nasal sinus surgery under remifentanil anesthesia.Methods Ninety pa-tients scheduled for nasal endoscopic sinus surgery with ASA physical status Ⅰ-Ⅱ were randomly divided into three groups(n=30 per group):remifentanil(R group),remifentanil plus 0.25 mg/kg etomidate(RA1 group),and remifen-tanil plus 0.5 mg/kg etomidate(RA2 group).All patients received continuous infusion of remifentanil and propofol for anesthesia maintenance.General patient information,visual analog scale(VAS)scores at 30 minutes,1 hour,2 hours,6 hours,12 hours,and 24 hours postoperatively,mean arterial pressure(MAP)and heart rate(HR)at induction(T0)and post-induction(T1),extubation time,Ramsay sedation scale score at extubation,tramadol consumption within 24 hours postoperatively,and incidence of postoperative adverse reactions such as nausea,dizziness,and mental symptoms were recorded.Results VAS scores at 30 minutes,1 hour,2 hours,and 6 hours postoperatively were significantly lower in the RA1 and RA2 groups compared to the R group(P＜0.05).MAP and HR at T1 were higher in the RA1 and RA2 groups than in the R group.There was no significant difference in extubation time among the three groups(P＞0.05).The number of patients requiring tramadol within 24 hours postoperatively was lower in the RA1 and RA2 groups(P＜0.05).The RA2 group had significantly more patients with a Ramsay sedation scale score of 1 at extubation compared to the R and RA1 groups(P＜0.05).The incidence of dizziness and mental symptoms postoperatively was higher in the RA1 and RA2 groups compared to the R group(P＜0.05),with a higher incidence in the RA2 group than in the RA1 group.There was no significant difference in the incidence of nausea,vomiting,shivering,or respiratory depression among the three groups(P＞0.05).Conclusion Etomidate combined with anesthesia induction contributes to hemody-namic stability during induction,alleviates postoperative pain,prevents high-dose remifentanil-induced hyperalgesia,does not affect postoperative recovery,and has a lower incidence of adverse reactions in patients receiving 0.25 mg/kg compared to 0.5 mg/kg.
Keywords：esketamineremifentanilendoscopic sinus surgerypostoperative pain
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 458-462 )