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To investigate the effective dose of esketamine inhibiting responses to gastroscopy insertion when combined with propofol in patients of different ages.
Patients scheduled for painless gastroscopy were selected and divided into three groups according to different ages: youth group (aged 1 - 40 years), middle age group (aged 41 - 64 years), and elderly group (aged 65 - 80 years). All patients were given propofol 1.5 mg·kg-1 combined with esketamine under intravenous anesthesia, dose of esketamine was determined by up-and-down sequential method, the initial dose of esketamine set at 0.2 mg·kg-1, and the common ratio of esketamine dose in adjacent patients was 1.1. When the response to gastroscopy insertion was positive reaction, the dose of esketamine was increased in the next patient, and decreased vice versa. The test ended after 7 crossovers were obtained. Probit analysis was used to calculate the median effective dose (ED50), 95% effective dose (ED95), and the corresponding 95% confidence interval (CI). Vital signs, awakening time, and the occurrence of adverse reactions were recorded.
The effective dose of esketamine inhibiting responses to gastroscopy insertion in patients of different ages when combined with propofol 1.5 mg·kg-1: the ED50 of the young group was 0.192 mg·kg-1 (95% CI: 0.181 to 0.202 mg·kg-1), ED95 was 0.209 mg·kg-1 (95% CI: 0.200 to 0.255 mg·kg-1) ; the ED50 of the middle age group was 0.157 mg·kg-1 (95% CI: 0.106 to 0.183 mg·kg-1), ED95 was 0.202 mg·kg-1 (95% CI: 0.179 to 0.576 mg·kg-1) ; the ED50 was 0.113 mg·kg-1 (95% CI: 0.085 to 0.131 mg·kg-1) and ED95 was 0.150 mg·kg-1 (95% CI: 0.131 to 0.303 mg·kg-1) in the elderly group. There were 2 cases of hypotension and 1 case of respiratory depression in the elderly group, while there were no significant adverse reactions in the other two groups.
When combined with propofol 1.5 mg·kg-1, the ED50 and ED95 of esketamine inhibiting response to gastroscopy insertion in patients of different ages show decreasing trends with age.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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