Anesthesia Effect of Different Doses of Esketamine Combined with Propofol in Hysteroscopic Surgery

ZHANG Zhijia; XU Shangjun; WANG Xinrui; WANG Xiaoqian; AN Xuebin

doi:10.3639/j.issn.2095-3097.2025.04.031

Abstract：Objective To observe the anesthetic effect of different doses of esketamine combined with propofol in hys-teroscopic surgery.Methods Sixty-four patients who underwent hysteroscopic surgery in the gynecology department of Beijing Pinggu Hospital between January 2024 and May 2024 were randomly divided into four groups(K1,K2,K3,K4;n=16 each).Preoperatively,patients in the K1 group,the K2 group,the K3 group,and the K4 group received intravenous administration of 0.2 mg/kg,0.3 mg/kg,0.4 mg/kg and 0.5 mg/kg of esketamine,respectively.Thirty seconds later,all groups received 2 mg/kg propo-fol via slow intravenous injection,followed by continuous infusion of 5 mg/(kg·h)of propofol for anesthesia maintenance.The incidence of intraoperative body movements in the four groups was recorded.Mean arterial pressure(MAP),heart rate,and SpO2 were observed and recorded 5 min before anesthesia(T0),at eyelash reflex disappeared(T1),uterus distension(T2),surgical closure(T3),and patients awakening(T4).The recovery time,operation time,total propofol dosage and propofol supplementation of the four groups were recorded.The perioperative adverse reactions of patients in the four groups were recorded.Results The incidence of body movements in the K3 and K4 groups was significantly lower than that in the K1 and K2 groups(P＜0.05).The MAP in the K3 group at T1 and T3 was higher than in K2 group(P＜0.05).The MAP of the K4 group from T1 to T3 was high-er than in the K2 group(P＜0.05).The recovery time of K4 group was significantly longer than those of K1,K2 and K3 groups(P＜0.05).The incidence of dizziness in the K4 group was significantly higher than those of K1,K2 and K3 groups(P＜0.05).Conclusion Administration of 0.4 mg/kg esketamine demonstrates optimal safety and more efficacy in hysteroscopic surgery,effectively inhibiting body movements,providing rapid recovery,and causing fewer adverse reactions.