Renal failure leading to hyperparathyroidism
Conditions
Interventions
The esketamine experimental group:Dilute 0.25 mg/kg of esketamine to 20 ml. Complete the infusion within 40 minutes after skin incision.
Saline control group:Infuse an equal amount of 20 mL of normal saline within 40 minutes after the skin incision.
Sponsors
The Second Affiliated Hospital of Anhui Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: 1. Age: 18 - 65 years old; 2. American Society of Anesthesiologists (ASA) physical condition: III - IV; 3. Diagnosed with chronic renal failure secondary to hyperparathyroidism and requiring surgical treatment; 4. Voluntarily participated in this study and signed the informed consent form; 5. Screening was conducted using the Questionnaire-9 (PHQ-9) and the Montgomery-Asberg Depression Rating Scale (MADRS). A PHQ-9 score of >= 5 points and a MADRS score of >= 12 points indicated mild to severe depressive symptoms;
Exclusion criteria
Exclusion criteria: 1. Have severe cardiovascular diseases (such as severe arrhythmia, heart failure, etc.); unstable ischemic heart disease, severe pulmonary hypertension; 2. Have a history of mental illness (such as schizophrenia, mania, etc.) or are currently taking anti-psychotic drugs; used analgesics and sedatives before the surgery; 3. Have a history of epilepsy or have a high risk of epilepsy; 4. Pregnant or lactating women; 5. Unable to cooperate with the scoring of observation indicators; 6. Complicated with other serious systemic diseases, such as severe liver dysfunction, advanced malignant tumors, etc., which may affect the evaluation of the trial results; 7. Body Mass Index (BMI) > 30 kg/m^2; 8. Liver dysfunction (alanine aminotransferase or aspartate aminotransferase value is twice the upper limit of normal or total bilirubin > 1.5 times the upper limit of normal); 9. Elevated intracranial pressure or intraocular pressure, chronic pain, mental illness or history of alcohol abuse;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of patients whose Montgomery-?sberg depression score decreased by at least 50% within 3 days after the surgery;; | — |
Secondary
| Measure | Time frame |
|---|---|
| The heart rate (HR) at the corresponding time point, the mean arterial pressure (MAP), and the number of times when MAP was less than 65 mmHg;;Improvement of depressive mood;Pain NRS score;The intraoperative PETCO2, peak airway pressure (Ppeak), minute ventilation volume (MV), and oxygenation index (SpO2) at the corresponding time point;The length of time that postoperative patients stay in the PACU;The occurrence of adverse events within 3 days after the operation (such as nausea and vomiting, dizziness, delirium, respiratory depression, hallucinations, nightmares, chills, diplopia, deterioration of renal function, etc.);Record the time for gastrointestinal function recovery (the time of first defecation and flatus passage);The dosage of vasoactive drugs used during the operation; the dosage of anesthesia maintenance drugs and analgesic drugs; the usage of postoperative analgesic drugs (such as the dosage of opioid drugs used in the patient-controlled intravenous analgesia pump);Simplified Postoperative Recovery Quality of Life Scale QoR-15 score; | — |
Countries
China
Contacts
Public ContactJiang Lingling
The Second Affiliated Hospital of Anhui Medical University
Outcome results
None listed