Efficacy and safety of propofol in combination with different esketamine doses for anesthesia during loop electrosurgical excision procedure

To investigate the efficacy and safety of propofol combined with different doses of esketamine (ESK) for anesthesia during loop electrosurgical excision procedure (LEEP). Ninety female patients undergoing LEEP were randomly allocated to three groups: group P (2 mg/kg propofol + saline), group propofol + esketamine (PK)1 (1.5 mg/kg propofol+ 0.5 mg/kg ESK), and group PK2 (1.5 mg/kg propofol + 0.25 mg/kg ESK). Parameters including mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), oxygen saturation (SPO2), and venous carbon dioxide (PvCO2) were recorded. Additionally, the need for supplemental propofol, jaw thrust maneuver or ventilation, postoperative awakening time, and adverse reactions were assessed. After induction, there was a significant decrease in MAP and HR observed in group P, while an increase was noted in group PK1 (both p < 0.05), with no notable change in group PK2 (p > 0.05). By the 5-minute mark post-induction, group PK1 exhibited RR and PvCO2 levels similar to pre-induction levels (p > 0.05), whereas group PK2 demonstrated an increase in RR and a decrease in PvCO2 (p < 0.05). The occurrence of jaw thrust maneuvers in group PK1 and group P was higher than in group PK2 (p < 0.05). Moreover, fewer patients necessitated additional intraoperative propofol in groups PK1 and PK2 compared to group P (p < 0.05). The time to awakening was shorter in group PK2 than in groups PK1 and P (p < 0.05). Additionally, the frequency of postoperative vertigo was higher in group PK1 compared to groups P and PK2 (p < 0.05), the incidence of nausea did not significantly differ among the three groups (p > 0.05). Notably, neither irritation nor delirium was reported in any of the three groups. This study suggested that propofol combined with low-dose esketamine characterized minimal disruption to circulatory and respiratory parameters, reduced occurrences of adverse reactions, and faster postoperative awakening.

Esketamine; LEEP; Propofol

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