Department of Anesthesiology, The Second Clinical Medical College, North Sichuan Medical College, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, China.
2 papers in the library · 5 citations · publishing 2025
Adding esketamine to remimazolam for sedation during painless gastroscopy reduces the required dose of remimazolam and improves hemodynamic stability. In a randomized double-blind study, the median effective dose (ED50) of remimazolam alone was 0.344 mg/kg, which fell to 0.289 mg/kg with 0.2 mg/kg esketamine and to 0.193 mg/kg with 0.4 mg/kg esketamine. Patients receiving esketamine had more stable blood pressure and less hypotension, but their recovery times were significantly longer. The combination offers advantages in safety and stability for endoscopic sedation.
Ultrasound stimulation applied to the thalamus before or after propofol anesthesia shortened the time to recovery of consciousness in mice. Mice receiving stimulation before anesthesia regained consciousness in about 20 minutes, and those stimulated after anesthesia in about 18 minutes, compared to about 33 minutes for sham-treated mice. The stimulation directly activated neural activity in the paraventricular thalamus and indirectly in the prefrontal cortex in the 60-100 Hz frequency band. Higher correlations in neural activity between these two brain regions were observed in the 8-13 Hz band, suggesting that both structures contribute to the transition of consciousness and can be modulated by transcranial ultrasound.