Effect of different doses of esketamine on the median effective concentration of propofol for inhibiting body movement during hysteroscopy.
Ji-Xiang Wan, Si-Si Zeng, Zhi-Qiang Wu, Yuan Wang, Na Wang, Fang-Jun Wang
Scientific Reports October 24, 2024 DOI: 10.1038/s41598-024-75902-3 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective, double-blind, up-down sequential allocation study Randomized Peer reviewed |
|---|---|
| Sample size | 90 |
| Population | Patients undergoing hysteroscopy |
| Interventions | Esketamine Propofol Midazolam |
| Dose | 0.1 mg/kg, 0.2 mg/kg, or 0.3 mg/kg esketamine |
| Topics | Esketamine |
| Keywords | Anesthetics Ec50 Anesthesia anaesthesia Anaesthetic Combination therapy Hysteroscopy hysteroscopic surgery Propofol diprivan Esketamine sp |
| Citations | 4 |
| Key points | Esketamine dose-dependently reduces the EC50 of propofol required to inhibit body movement during hysteroscopy, with 0.3 mg/kg being the optimal dose. |
Abstract
The objective of this study is to investigate the effects of various doses of esketamine on the median effective concentration (EC50) of propofol required for inhibiting body movement during hysteroscopy. Additionally, this research aims to explore the pharmacodynamic interactions between esketamine and propofol. Prospective, double-blind, up-down sequential allocation study. Operating room, post-anesthesia care unit (PACU), and general ward. A total of 90 patients were allocated into three groups in a randomized, double-blinded manner as follows: 0.1 mg/kg esketamine combined with propofol intravenous injection (EP0.1) group, 0.2 mg/kg esketamine combined with propofol intravenous injection (EP0.2) group, 0.3 mg/kg esketamine combined with propofol of intravenous injection (EP0.3) group. For the initial patient in each group, the starting effector target concentration of propofol was set at 4 µg/ml. Each patient received an initial intravenous injection of 0.04 mg/kg midazolam, followed by the administration of the appropriate dose of esketamine. Ten seconds after the esketamine injection, propofol was administered intravenously to achieve the target concentration. In accordance with the sequential method principle, the concentration of propofol for the subsequent patient was adjusted based on the response of the previous patient. Effective inhibition of body movement was defined as the absence of any involuntary body movements throughout the entire surgical process. If the previous patient exhibited body movements, the propofol concentration for the next patient was increased by 0.5 µg/ml; conversely, if no movements were observed, it was decreased by 0.5 µg/ml. The up-down sequential allocation method and probit regression were used to calculate the EC50 of propofol. Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and Depression (HADS-D) score, adverse events, hemodynamic changes, demographic data and clinical characteristics. The EC50 of propofol was 3.849 μg/ml (95% CI: 3.419-4.281) in the EP0.1 group, 3.641 μg/ml (95% CI: 2.807-4.200) in the EP0.2 group, and 3.417 μg/ml (95% CI: 2.845-3.852) in the EP0.3 group. These findings suggest that esketamine can dose-dependently reduce the EC50 of propofol. Esketamine can dose-dependently reduce the EC50 of propofol in hysteroscopy, while concurrently lowering patients' HADS-A and HADS-D scores 24 h post-operation. It is concluded that the optimal dose of esketamine, when combined with propofol for hysteroscopy, is 0.3 mg/kg.
Comparable studies
Other randomized controlled trials on esketamine, most cited first.
Citations in the library
Cites 3
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial American Journal of Psychiatry August 28, 2013