Effect of Subanaesthetic Dose of Esketamine in Combination with Dexme-detomidine on Intraoperative Sedation,Analgesia and Safety in Patients with OVCF

FAN Xu; YUAN Linlin; SHEN Boxiong

doi:10.3969/j.issn.1002-3429.2023.10.026

Abstract：Objective To investigate the effects of subanesthetic Esketamine combined with Dexmedetomidine on in-traoperative sedation,analgesia and safety in patients with osteoporotic vertebral compression fracture(OVCF).Methods A total of 101 patients with OVCF who underwent vertebroplasty from October 2020 to December 2022 were selected.According to the different narcotic drugs,they were divided into two groups:research group(n =51)and control group(n =50).The subanesthetic dose of Esketamine combined with Dexmedetomidine was administered in the research group,and Sufentanil combined with Dexmedetomidine was administered in the control group.The surgical conditions of the two groups were com-pared.Respiratory circulatory indicators[heart rate,mean arterial pressure(MAP),oxygen saturation,respiration],pain[Visual Analogue Scale(VAS)score]and alert sedation[Observer's Assessment of Alertness/Sedation Scale(OAA/S)score],stress indicators[aldosterone(ALD),cortisol(Cor),norepinephrine(NE)],postoperative comfort[Bruggman Comfort Score(BCS)]and cognitive function[Mini-mental State Examination(MMSE)]at the time of entry,incision(T1),bone cement injection(T2),and at the end of surgery(T3)and intraoperative adverse reactions were compared be-tween the two groups.Results There was no significant difference in surgical condition between the two groups(P＞0.05).At T1,T2 and T3,heart rate,MAP,respiration,VAS score,OAA/S score and serum ALD,Cor and NE in the research group were lower than those in the control group(P＜0.05,P＜0.01).At 3,12,24 and 48 h after operation,the BCS of the research group was higher than that of the control group(P＜0.01).There was no significant difference in the total inci-dence of adverse reactions between the research group and the control group(13/51,25.49%vs.18/50,36.00%;P＞0.05).Conclusion The subanesthetic dose Esketamine combined with Dexmedetomidine can alleviate stress response,sta-bilize respiratory circulation,and have good sedative and analgesic effect in OVCF patients undergoing vertebroplasty,with good safety.