Esketamine Combined With Remimazolam on Postoperative Sleep Disturbance and Anxiety in Patients

Postoperative sleep disturbance (PSD) occur in the form of sleep deprivation, circadian rhythm disturbance, and structural abnormalities, and have a high incidence in patients undergoing surgery. Postoperative sleep disorders can lead to postoperative delirium and cognitive dysfunction, aggravate postoperative acute pain, and delay postoperative recovery.

Benzodiazepines have a certain sedative hypnotic anti-anxiety effect, and remimazolam as a new benzodiazepine, its sedative hypnotic anti-anxiety effect is worthy of further exploration.Esketamine is an NMDA receptor antagonist with analgesic and sedative effects, and is widely used in clinical treatment of refractory depression. For patients undergoing surgery, in addition to sedation and analgesia, whether the intraoperative use of esketamine has positive effects on postoperative sleep disturbance and anxiety is worth exploring.

Inclusion criteria

• Age 20-65 years old;
• ASA classification is grade I-III;
• Elective surgery is proposed
• BMI of 19-30 kg/m2;
• Patients who agreed to enroll in this study voluntarily

Exclusion criteria

• Those who are known to be allergic to the drug ingredients in this study and their allergic constitution;
• Allergic history of general anesthesia drugs, opioid drugs, non-steroidal drugs;
• History of neurological diseases; History of chronic pain; Drug and alcohol addiction; A long history of opioid use; Opiates were given 48 hours before surgery;
• ASA rating of IV or V;
• Coronary heart disease, bronchial asthma, severe hypertension, severe blood system dysfunction, liver and kidney function, electrolyte abnormalities;
• History of gastrointestinal disease (peptic ulcer, Crohn's disease, ulcerative colitis);
• Respiratory insufficiency, respiratory failure;
• Patients who refused to use intravenous PCA for analgesia;
• Pregnant or lactating women;
• BMI<18 kg/m2 or BMI>30kg/m2;
• Poor compliance, unable to complete the experiment according to the study plan;
• Participants who have participated in clinical trials of other drugs within the last 4 weeks;
• Any circumstances deemed unsuitable for inclusion by the researcher for any reason.