Comparison of the Effects of Esketamine/Propofol and Sufentanil/Propofol on the Incidence of Intraoperative Hypoxemia during Bronchoscopy: Protocol for a Randomized, Prospective, Parallel-Group Trial

Background: Propofol, ketamine, and sufentanil are the most commonly used anesthetics during bronchoscopy, alone or in combination, for sedation. Esketamine is an s-enantiomer of ketamine racemate and has both sedative and analgesic effects. Esketamine does not inhibit respiration and maintains hemodynamic stability. This study aims to compare the clinical efficacy of esketamine/propofol with sufentanil/propofol for patients during bronchoscopy. Methods: Patients undergoing bronchoscopy will be randomly assigned to receive either sufentanil/propofol (sufentanil group; n = 33; sufentanil: 0.2 μg/kg) or esketamine/propofol (esketamine group; n = 33; esketamine: 0.2 mg/kg) for sedation and analgesia. Intraoperative clinical information, general anesthetic drug dosage, the incidence of intraoperative hypoxemia, total time of hypoxemia, awakening time, delirium, nausea and vomiting, adverse reactions, and patient satisfaction will be collected. Discussion: Hypoxia has detrimental effects on patients with respiratory disease. Ameliorating hypoxemia in patients undergoing bronchoscopy is critical. Our results will provide effective sedation with esketamine in patients undergoing bronchoscopy. Trial registration: Chinese clinical trial registry: ChiCTR2200058990

Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey.

Inadvertent intraoperative hypothermia (core temperature 2 h (OR = 3.44, 95% CI 1.90-6.22,), and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45-4.12) significantly increased the risk of hypothermia.The incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids

Risk factors associated with intraoperative hypothermia, Beijing, China (N = 830).

<p>OR, Odds Ratio, Significant level indicates as P<0.05.</p><p>¹ adjusted OR were presented after adjusting all the variables in above table.</p><p>² patients receiving unwarmed IV fluid only</p><p>Risk factors associated with intraoperative hypothermia, Beijing, China (N = 830).</p

Change of intraoperative core temperature during operations.

<p>Patients’ core temperature was measured at the tympanic membrane beginning every 15 minutes after the induction of anesthesia and until the end of the operation. A total of 830 subjects were enrolled in the study; 89 (10.7%) received active warming, and 741(89.3%) received no warming.</p

Patient Demographics and Anesthesia/Surgery Data, Beijing, China (N = 830).

<p>¹ Magnitude of surgery as below: minor surgery: excision of lesion of skin; drainage of breast abscess, etc. Intermediate surgery: primary repair of inguinal hernia; excision of varicose vein(s) of leg; tonsillectomy/adenotonsillectomy; knee arthroscopy, etc. major surgery: total abdominal hysterectomy; endoscopic resection of prostate; lumbar discectomy; thyroidectomy, etc. major surgery plus: total joint replacement; lung operations; colonic resection; radical neck dissection; neurosurgery; cardiac surgery)</p><p>² Arthroscopic, laparoscopic, etc</p><p>³ Time from incision to closure</p><p>⁴ Time from induction to discontinuation of anesthetic agents</p><p>Patient Demographics and Anesthesia/Surgery Data, Beijing, China (N = 830).</p

Incidence of intraoperative hypothermia, patient warming and clinical outcome (N = 830).

<p>¹ passive warming includes comforter, blanket etc</p><p>² active warming includes electric heated blanket, space heater etc</p><p>Incidence of intraoperative hypothermia, patient warming and clinical outcome (N = 830).</p