A comparative study of Esketamine-Dexmedetomidine and Sufentanil-Dexmedetomidine for sedation and analgesia in lung tumor percutaneous radiofrequency ablation(PRFA):A randomized double-blind clinical trial

Abstract

Abstract Objection: To observe and evaluate the effectiveness and safety of Esketamine or Sufentanil combined with Dexmedetomidine for sedation and analgesia in lung tumor percutaneous radiofrequency ablation (PRFA), so as to provide a clinical basis for the optimization of sedation and analgesia in lung tumor PRFA protocols outside the operating room. Methods: In this trial, 44 patients aged from 37 to 84 years old undergoing lung tumor PRFA were enrolled and assigned into the Group E (n=22, Esketamine 0.2mg/kg) or Group S (n=22,Sufentanil 0.1μg/kg ) group. Dexmedetomidine was infused intravenously as a sedative in both groups. The modified observer's assessment of alertness and sedation scale(MOAAS),the physical movement pain scale, intraoperative vital signs, anesthesia recovery time, radiologist and patient satisfaction rates，incidence of respiratory depression, incidence of postoperative nausea and vomiting were recorded. Results:Although there was no significant difference in the physical movement pain scale, blood oxygen saturation and incidence of perioperative adverse events between the two groups during the ablation, the MOAAS, mean arterial pressure(MAP) and heart rate(HR) were higher in Group E than in Group S. Anesthesia recovery time were shorter in Group E than in Group S, radiologist satisfaction was better in Group E than in Group S, but there was no statistical difference between the two groups in terms of patient satisfaction. Conclusion: Either Esketamine or Sufentanil combined with Dexmedetomidine are safe for lung tumor PRFA. However, in elderly patients with multiple underlying diseases, low-dose Esketamine combined with Dexmedetomidine has fewer hemodynamic effects on patients, milder respiratory depression, shorter recovery time, and better radiologist satisfaction because of its better controllability of sedation depth. Trial registration: Chinese Clinical Trail Registry (Registration number#ChiCTR ChiCTR21000500 21);Date of Registration:16/08/2021