Effect of Esketamine Added to Propofol Sedation on Desaturation and Hypotension in Bidirectional Endoscopy: A Randomized Clinical Trial
Authors' conclusion
In this randomized clinical trial of patients undergoing same-visit bidirectional endoscopy, the administration of low-dose esketamine resulted in an approximately 61% reduction in the incidence of desaturation and hypotension, accompanied by decreased propofol requirements.
Study context
- Population
- Patients scheduled for same-visit bidirectional endoscopy under propofol sedation, 3 teaching hospitals in China, 2022660 completed
- Participants
- 663 patients
- Comparison
- Low-dose esketamine vs saline placebo added to propofol-based sedation
- Esketaminen = 331
- Placebon = 329reference
- Primary endpoint
- Composite of:
- Desaturation
- Hypotension during the procedures
Methodological detailsmulticentre, double-blind, placebo-controlled
- Multicentre
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Each group vs placeboOdds ratio (95% CI)P value
Esketamine
0.34(0.21–0.54)
P < 0.001- Esketamine
- difference −12.8 percentage points
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| DesaturationFalse discovery rate q = .01 | 0.36 (0.18–0.72) | |
| HypotensionQ < .001 | 0.33 (0.18–0.60) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Difference (mg) (95% CI) | |
|---|---|---|
| Propofol requirementsQ < .001 | −58.9 (−65.7 to −52.2) | |
| −100−50050Difference, mg (linear scale) |
Other secondary outcomes (pain, fatigue, nausea or vomiting, dizziness or headache, hallucination or nightmare, satisfaction)
- No significant effects
Original publication
Effect of Esketamine Added to Propofol Sedation on Desaturation and Hypotension in Bidirectional Endoscopy: A Randomized Clinical Trial. JAMA Netw Open. Published 1 December 2023. doi:10.
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