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Corresponding author: Liu Tao, hzyylt@163.com

DOI: 10.12201/bmr.202411.00014

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  Abstract: Objective: To explore the impact of non-opioid anesthesia on the occurrence of emergence agitation (EA) during the recovery period after transurethral resection of the prostate (TURP).Methods: A single-center randomized controlled study design was employed, including 78 patients classified as American Society of Anesthesiologists (ASA) I or II, aged 18 to 80 years, undergoing elective TURP. Patients were randomly divided into two groups of 39: the conventional group (F group) and the non-opioid group (LY group). The anesthesia induction regimen for the F group included fentanyl (3 μg/kg) + propofol (2 mg/kg), while the LY group received esketamine (0.3 mg/kg) + propofol (2 mg/kg). EA was assessed every 5 minutes for 30 minutes following the removal of the laryngeal mask using the Ramsay sedation scale. Pain was evaluated with the VAS scoring method. Mean arterial pressure (MAP) and heart rate were recorded at admission (T0), immediately after laryngeal mask insertion (T1), 3 minutes after insertion (T2), 6 minutes after insertion (T3), and 9 minutes after insertion (T4). Data on rescue analgesia, surgical duration, recovery time, and the occurrence of adverse reactions such as agitation, nausea and vomiting, hypoxemia, nightmares, and hallucinations during PACU recovery were also recorded.Results: Compared to the F group, the LY group had a lower incidence of postoperative EA, maximum VAS score, and extubation time (P<0.05), while the maximum Ramsay score in the LY group was higher than that in the F group (P>0.05). No statistically significant differences were observed in rescue analgesia rates, surgical duration, or adverse reaction rates between the two groups (all P>0.05). The time effect of heart rate and the interaction effect of time and group were statistically significant (P<0.05); the time effect of MAP and the interaction effect of time and group were also statistically significant (P<0.05). The heart rate differences between T1-T4 were statistically significant (P<0.05), with no differences in the control group at each time point (P>0.05). In the experimental group, heart rate increased from T1-T2 compared to T0 (P<0.05), with no differences at other time points. The average pressure differences between T1-T4 were statistically significant (P<0.05), with the control group showing a significant decrease in average pressure from T0-T5 (P<0.05). The experimental group showed a decrease in average pressure from T2-T4 compared to T0 (P<0.05), with no differences at other time points.Conclusion: The non-opioid anesthesia regimen reduces the incidence of EA and postoperative pain scores in TURP patients, without increasing adverse reactions during recovery.

  Key words: Non-opioid; anesthesia, prostate; resection, emergence; agitation, esketamine, dexmedetomidine.

  Submit time: 8 November 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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