Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial
Abstract Background Esketamine has been increasingly used as an adjuvant for propofol-based induction. However, the effective esketamine dose for this indication remains unclear. The authors investigated the effect of different intravenous bolus low doses of esketamine pretreatment on the propofol r...
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BMC
2025-04-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-03058-2 |
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| author | Rui An Chunnan Lin Zeguang Lu Wenqian Lin Hongying Tan Tianhua Zhang Huiting Li Longhui Cao |
| author_facet | Rui An Chunnan Lin Zeguang Lu Wenqian Lin Hongying Tan Tianhua Zhang Huiting Li Longhui Cao |
| author_sort | Rui An |
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| description | Abstract Background Esketamine has been increasingly used as an adjuvant for propofol-based induction. However, the effective esketamine dose for this indication remains unclear. The authors investigated the effect of different intravenous bolus low doses of esketamine pretreatment on the propofol requirements and the onset time of cisatracurium during anesthesia induction. Methods 140 patients undergoing elective surgery under general anesthesia were randomly allocated into four groups: pretreatment with saline (Group C), pretreatment with 0.1 mg/kg esketamine (Group K0.1), pretreatment with 0.3 mg/kg esketamine (Group K0.3), and pretreatment with 0.5 mg/kg esketamine (Group K0.5). The propofol dosage was recorded when the eyelash reflex disappeared and the Index of Consciousness (IoC) value reached 60 during the infusion. The onset time for cisatracurium was recorded. Results The total dose of propofol at the point of eyelash reflex loss was significantly lower in group K0.5 than in groups K0.3 (P = 0.019), K0.1 (P < 0.001) and C (P < 0.001). The dose of propofol at the point of the loss of eyelash reflex was lower in group K0.3 than in groups K0.1 (P = 0.006) and C (P < 0.001). The total dose of propofol at an IoC value of 60 was significantly higher in group K0.5 than in groups K0.1 (P < 0.001) and C (P < 0.001). The dose of propofol at an IoC value of 60 was higher in group K0.3 than in groups K0.1 (P = 0.009) and C (P < 0.001). The onset time of cisatracurium during induction was not significantly different among the groups. Conclusion Esketamine decreases the dose of propofol in a dose-dependent manner at the point of the loss of eyelash reflex, while 0.5 mg/kg esketamine and 0.3 mg/kg esketamine pretreatment before induction significantly increase the dose of propofol at the targeted IoC value of 60. Esketamine does not affect the onset time of cisatracurium when it is combined with propofol during IoC-guided induction of anesthesia. Clinical trial number Clinical trial number and registry URL: ChiCTR2000041041, registration date: December 16, 2020 http://www.chictr.org.cn . |
| format | Article |
| id | doaj-art-74586d3ac03649f78d3dd79a0fc3fb41 |
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| publishDate | 2025-04-01 |
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| spelling | doaj-art-74586d3ac03649f78d3dd79a0fc3fb412025-08-20T02:10:46ZengBMCBMC Anesthesiology1471-22532025-04-012511810.1186/s12871-025-03058-2Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trialRui An0Chunnan Lin1Zeguang Lu2Wenqian Lin3Hongying Tan4Tianhua Zhang5Huiting Li6Longhui Cao7Department of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterAbstract Background Esketamine has been increasingly used as an adjuvant for propofol-based induction. However, the effective esketamine dose for this indication remains unclear. The authors investigated the effect of different intravenous bolus low doses of esketamine pretreatment on the propofol requirements and the onset time of cisatracurium during anesthesia induction. Methods 140 patients undergoing elective surgery under general anesthesia were randomly allocated into four groups: pretreatment with saline (Group C), pretreatment with 0.1 mg/kg esketamine (Group K0.1), pretreatment with 0.3 mg/kg esketamine (Group K0.3), and pretreatment with 0.5 mg/kg esketamine (Group K0.5). The propofol dosage was recorded when the eyelash reflex disappeared and the Index of Consciousness (IoC) value reached 60 during the infusion. The onset time for cisatracurium was recorded. Results The total dose of propofol at the point of eyelash reflex loss was significantly lower in group K0.5 than in groups K0.3 (P = 0.019), K0.1 (P < 0.001) and C (P < 0.001). The dose of propofol at the point of the loss of eyelash reflex was lower in group K0.3 than in groups K0.1 (P = 0.006) and C (P < 0.001). The total dose of propofol at an IoC value of 60 was significantly higher in group K0.5 than in groups K0.1 (P < 0.001) and C (P < 0.001). The dose of propofol at an IoC value of 60 was higher in group K0.3 than in groups K0.1 (P = 0.009) and C (P < 0.001). The onset time of cisatracurium during induction was not significantly different among the groups. Conclusion Esketamine decreases the dose of propofol in a dose-dependent manner at the point of the loss of eyelash reflex, while 0.5 mg/kg esketamine and 0.3 mg/kg esketamine pretreatment before induction significantly increase the dose of propofol at the targeted IoC value of 60. Esketamine does not affect the onset time of cisatracurium when it is combined with propofol during IoC-guided induction of anesthesia. Clinical trial number Clinical trial number and registry URL: ChiCTR2000041041, registration date: December 16, 2020 http://www.chictr.org.cn .https://doi.org/10.1186/s12871-025-03058-2EsketamineAnesthesia inductionPropofolOnset time |
| spellingShingle | Rui An Chunnan Lin Zeguang Lu Wenqian Lin Hongying Tan Tianhua Zhang Huiting Li Longhui Cao Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial BMC Anesthesiology Esketamine Anesthesia induction Propofol Onset time |
| title | Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial |
| title_full | Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial |
| title_fullStr | Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial |
| title_full_unstemmed | Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial |
| title_short | Effect of pretreatment with low-dose Esketamine on the Propofol requirements and the onset time of cisatracurium during the induction of general anesthesia: a prospective, randomized, double-blinded trial |
| title_sort | effect of pretreatment with low dose esketamine on the propofol requirements and the onset time of cisatracurium during the induction of general anesthesia a prospective randomized double blinded trial |
| topic | Esketamine Anesthesia induction Propofol Onset time |
| url | https://doi.org/10.1186/s12871-025-03058-2 |
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