This study intends to conduct a prospective randomized controlled trial to implement esketamine-assisted anesthesia in patients undergoing open thyroidectomy, in order to observe the effect of esketamine on coughing during extubation in thyroidectomy patients.
Patients scheduled for elective open thyroid surgery
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
DrugAfter anesthesia induction, continue to administer esketamine by infusion at 0.1 mg/kg/h during the maintenance phase of anesthesia, and stop the infusion of esketamine during suturing.
Normal Saline
DrugAfter anesthetic induction, an equal amount of saline is continuously infused by pump during the maintenance phase of anesthesia, and the saline infusion is stopped during suturing;
Incidence of coughing during tracheal extubation
2 point scales; 0=None; 0 = Did not occur; 1 = Occurred;
Severity of coughing during tracheal extubation
4 grade scales; 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
3-level scale; 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, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation
Airway pressure 5 minutes after intubation and at the end of surgery
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