艾司氯胺酮联合右美托咪定及利多卡因麻醉诱导抑制气管插管反应OACSTPCD

Objective To investigate the median effective dose(ED50)of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine under opioid-free anesthesia(OFA).Methods Adult patients aged 18-59 years with body mass index(BMI)<30 kg/m² and ASA grade Ⅰ or Ⅱ were selected for endotracheal intubation general anesthesia.Dixon sequential method was adopted.The initial dose of esketamine was 0.5 mg/kg,and the dose of the next patient was determined according to the tracheal intubation response.The ratio of adjacent doses was 1∶1.1.The ED50 and 95%confidence interval(CI)of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine OFA were calculated.Results A total of 29 patients were included for statistical analysis.Tracheal intubation reaction was positive in 15 cases(positive group)and negative in 14 cases(negative group).In the positive group,3 cases had cough reaction during tracheal intubation.The ED50 of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine OFA was 0.448 mg/kg,and the corresponding 95%CI was 0.421-0.476 mg/kg.Conclusion In the OFA of esketamine combined with dexmedetomidine and lidocaine,0.448 mg/kg of esketamine results in 50%of the maximum response intensity for inhibiting tracheal intubation response.