This study intends to implement esketamine-assisted anesthesia in patients undergoing non-inflatable transoral endoscopic thyroidectomy through a prospective randomized controlled trial, in order to observe the effect of esketamine on coughing during extubation in thyroidectomy patients.
Patients scheduled for endotracheal intubation-free thyroid surgery under oral endoscopy
ASA class I-II
Voluntarily participate in the study and sign the informed consent form
Body Mass Index > 30 kg/m²
Patients with unstable ischemic cardiomyopathy, pulmonary hypertension, poorly controlled or untreated hypertension (arterial hypertension, resting systolic/diastolic blood pressure >180/100 mmHg)
Hepatic or renal dysfunction
History of oral, maxillofacial, neck, or airway surgery, or pathological structural alterations
Parallel
Esketamine（iv）
DrugDuring anesthesia induction, administer esketamine intravenously at 0.5 mg/kg. Once muscle relaxation is achieved, under direct laryngoscopic visualization, spray physiological saline (3 ml) above the glottis, at the glottis, and below the glottis.
ESK spray
DrugDuring anesthesia induction, Once muscle relaxation is achieved, under direct laryngoscopic visualization, spray esketamine at the supraglottic, glottic, and subglottic levels: 3 ml (0.5 mg/kg).
Normal Saline
DrugDuring anesthesia induction, intravenous injection of an equal amount of normal saline is administered. After achieving muscle relaxation, under direct laryngoscopic view, spray normal saline over the supraglottic, glottic, and subglottic areas: 3 ml.
Incidence of coughing during tracheal extubation
0=None; 0 = Did not occur; 1 = Occurred;
Severity of coughing during tracheal extubation
Grade 0: No choking cough; Grade 1: Single cough episode, considered mild choking cough; Grade 2: Intermittent cough, lasting less than 5 seconds, considered moderate choking cough; Grade 3: Continuous severe cough, lasting more than 5 seconds, considered severe choking cough; The higher the degree, the worse it is.
Agitation score during tube removal
1: Awake and calm; 2: Mild agitation but can be comforted; 3: Moderate agitation, difficult to comfort; 4: Severe agitation, cannot be comforted; The higher the degree, the worse the situation.
Blood pressure
Baseline , post-induction, 1 minute after intubation, at the end of the surgery, 1 minute after extubation, and 5 minutes after extubation.
Airway pressure 5 minutes after intubation and at the end of surgery
Click on the lead sponsor to view all of their trials.
This trial is not recruiting at the moment. You can still explore other options:
