Effect of esmketamine on trigeminal cardiac reflex in patients with trigeminal neuralgia undergoing percutaneous balloon compression

Zhang Huanhuan; He Jinhua; Zhang Meng; Yang Ge; Zhang Yu; Li Jianli

doi:10.3760/j.issn.1673-4777.2024.07.012

Abstract：Objective To investigate the effect of esketamine on trigeminal cardiac reflex(TCR)in patients with trigeminal neuralgia undergoing percutaneous balloon compression(PBC).Methods A total of 80 patients with trigeminal neuralgia who underwent PBC in Hebei General Hospital from January to August 2023 were selected,and they were divided into esketamine group and control group according to the random number table method,with 40 cases in each group.The control group was induced with midazolam,sufentanil,benzenesulfonate cisatracurium,and propofol.The esketamine group was induced with midazolam,sufentanil,benzenesulfonate cisatracurium,propofol,and esketamine.The heart rate and mean arterial pressure(MAP)before induction of anesthesia(T0),before the start of surgery(T1)and at the time of foramen ovale puncture(T2),the incidence of TCR at the time of foramen ovale puncture,and the incidence of perioperative adverse reactions were compared between the two groups.Results The heart rate and MAP of patients in the two groups at time points T1 and T2 were significantly lower than those at time point T0,and the heart rate and MAP of the esketamine group at time points T1 and T2 were significantly higher than those of the control group(all P＜0.05).The incidence of TCR was significantly lower in the esmketamine group than that in the control group[15.0％(6/40)vs 45.0％(18/40)](P＜0.05).There was no significant difference in the total incidence of adverse reactions between the esmketamine group and the control group[22.5％(9/40)vs 12.5％(5/40)](P＞0.05).Conclusion Esketamine can reduce the incidence of TRC in patients with trigeminal neuralgia undergoing PBC,and improve the perioperative safety of patients.