Median Effective Dose of Esketamine Pretreatment to Prevent Sufentanil-induced Cough

Median Effective Dose of Esketamine Pretreatment to Prevent Sufentanil-induced Cough

Sufentanil has the advantages of fast onset time, strong analgesic function and cardiovascular stability, and is widely used during general anesthesia induction. However, sufentanil can cause cough during induction of general anesthesia. Different studies have reported that the incidence of sufentanil-induced cough ( SIC ) during anesthesia is 16-42 %. This pathological condition may lead to damage to the central nervous system, increase the risk of reflux and aspiration, increase intracranial pressure and intraocular pressure, and endanger patients with cerebral aneurysms and ocular trauma. Therefore, at the moment of advocating comfortable anesthesia medical services, sufentanil-induced cough response is a problem that clinical anesthesiologists need to focus on and urgently solve. It has been reported that ketamine can reduce the incidence of cough caused by opioids. Esketamine is a pure dextro-enantiomer of ketamine and an NMDA antagonist with potent analgesic and bronchodilator effects. In this study, Dixon sequential method was used to study the median effective dose ( ED50 ) of intravenous esketamine pretreatment to prevent sufentanil-induced cough, and to explore the effect of age on ED50. To provide reference for clinical rational selection of esketamine dose.

Inclusion Criteria:

ASA I-II patients aged 18-59 years undergoing elective surgery under general anesthesia

Exclusion Criteria:

1. Preoperative intracranial pressure;
2. intra-abdominal pressure or intraocular pressure increased ;
3. have a history of cardiovascular and cerebrovascular diseases ;
4. have a history of asthma ;
5. have a history of chronic cough ;
6. have a history of smoking ;
7. there was a history of upper respiratory tract infection 2 weeks before operation;
8. Patients received opioid therapy 2 weeks before surgery.;
9. Patients who received angiotensin converting enzyme inhibitors, bronchodilators or steroids 2 weeks before surgery ;
10. abnormal liver and kidney function ; weight exceeded 20 % of the ideal weight ( male height - 100, female height - 105 ).