Scholarlink

Background <p>Elderly patients undergoing transbronchial lung biopsy (TBLB) face anesthesia-associated complications from cardiopulmonary impairment and comorbidities, so geriatric TBLB anesthetic management is crucial.</p> Aim <p>To compare esketamine and sufentanil on hemodynamics, airway pressure, bronchospasm incidence and oxygenation in elderly TBLB induction.</p> Methods <p>Using a retrospective propensity score matching (PSM) cohort study design, We enrolled recruited elderly patients undergoing TBLB at the Hospital between January 2024 and August 2025. Patients were divided by anesthesia induction protocol: control group (Group S, sufentanil combination) and experimental group (Group E, esketamine combination). A 1:1 PSM method was used to match 40 patients in each group. Primary outcomes included heart rate (HR), mean arterial pressure (mBP), blood oxygen saturation (SpO₂) and airway pressure (Paw) at the time of entering the operating room (T0), LMA insertion (T1), bronchoscopic biopsy (T2), the end of operation (T3), and LMA removal (T4). The incidence of bronchial smooth muscle spasm was observed under the microscope. Secondary outcomes were extubation time, recovery time, and PONV incidence.</p> Results <p>After PSM, baseline characteristics were comparable (<i>P</i>&gt;0.05). At time points of high stimulation (T1, T2), Group E had significantly higher HR and mBP than Group S (<i>P</i>&lt;0.05). This translated to a markedly lower incidence of clinically significant hypotension requiring intervention in Group E (12.5% vs. 45.0%, <i>P</i> = 0.001). Group E also exhibited significantly lower Paw at T1-T3, higher SpO₂ at T2, and a markedly reduced incidence of bronchospasm (5.0% compared to 22.5%, <i>P</i>&lt;0.05). Recovery profiles favored Group E, showing shorter extubation and recovery times alongside a lower incidence of PONV (<i>P</i>&lt;0.05).</p> Conclusions <p>In this retrospective study, esketamine showed associations with improved hemodynamic stability, lower incidence of bronchospasm and airway pressure, reduced PONV, and better oxygenation during induction in elderly TBLB patients, suggesting its potential as a viable alternative.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Esketamine vs. sufentanil for anesthesia induction in elderly patients undergoing transbronchial lung biopsy (TBLB): effect on hemodynamic stability, airway reactivity, and oxygenation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月10日

查看全文
  • MingChong Wang,
  • WenHua Zhang

摘要

Background

Elderly patients undergoing transbronchial lung biopsy (TBLB) face anesthesia-associated complications from cardiopulmonary impairment and comorbidities, so geriatric TBLB anesthetic management is crucial.

Aim

To compare esketamine and sufentanil on hemodynamics, airway pressure, bronchospasm incidence and oxygenation in elderly TBLB induction.

Methods

Using a retrospective propensity score matching (PSM) cohort study design, We enrolled recruited elderly patients undergoing TBLB at the Hospital between January 2024 and August 2025. Patients were divided by anesthesia induction protocol: control group (Group S, sufentanil combination) and experimental group (Group E, esketamine combination). A 1:1 PSM method was used to match 40 patients in each group. Primary outcomes included heart rate (HR), mean arterial pressure (mBP), blood oxygen saturation (SpO₂) and airway pressure (Paw) at the time of entering the operating room (T0), LMA insertion (T1), bronchoscopic biopsy (T2), the end of operation (T3), and LMA removal (T4). The incidence of bronchial smooth muscle spasm was observed under the microscope. Secondary outcomes were extubation time, recovery time, and PONV incidence.

Results

After PSM, baseline characteristics were comparable (P>0.05). At time points of high stimulation (T1, T2), Group E had significantly higher HR and mBP than Group S (P<0.05). This translated to a markedly lower incidence of clinically significant hypotension requiring intervention in Group E (12.5% vs. 45.0%, P = 0.001). Group E also exhibited significantly lower Paw at T1-T3, higher SpO₂ at T2, and a markedly reduced incidence of bronchospasm (5.0% compared to 22.5%, P<0.05). Recovery profiles favored Group E, showing shorter extubation and recovery times alongside a lower incidence of PONV (P<0.05).

Conclusions

In this retrospective study, esketamine showed associations with improved hemodynamic stability, lower incidence of bronchospasm and airway pressure, reduced PONV, and better oxygenation during induction in elderly TBLB patients, suggesting its potential as a viable alternative.