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Effects of Esketamine-Dexmedetomidine Combination on Immediate Postprocedural Oxygenation Index in Severe Pneumonia Patients Undergoing Bedside Fiberoptic Bronchoscopic Sputum Aspiration: A Prospective Randomised Controlled Trial

Wang Y, Zhang R, Wu B, Han J, Li Y, Zhang L

Drug design, development and therapy, 2025

90 participants · 1 citation

Abstract

Purpose: The aim was to investigate the effect of esketamine-dexmedetomidine (ESK-DEX) combination on immediate postprocedural oxygenation index (OI) in severe pneumonia patients undergoing bedside fiberoptic bronchoscopic (FOB) sputum aspiration, and provide clinical reference.

Methods: A total of 90 patients diagnosed with severe pneumonia receiving non-invasive mechanical ventilation (NIV) who underwent bedside FOB were randomly and evenly divided into three groups: Group C (local anesthesia alone), Group D (DEX alone), Group ED (ESK-DEX). The primary outcome was the OI immediately after procedure (T1). The secondary outcomes: the OI was calculated at 6 h (T2), 12 h (T3), and 24 h (T4) after procedure; the mean arterial pressure (MAP) and heart rate (HR) were assessed at the following time points: FOB tip passage through nostril (t1), glottis (t2), 5 minutes after procedure (t3), and upon procedure completion (t4); Additionally, perioperative adverse events were also documented.

Results: The Group ED demonstrated significantly higher OI compared to Group C at T1 (mean difference, -8.1; 95% CI, -13.48, -2.64; P=0.001). Similarly, the Group ED demonstrated significantly higher OI compared to Group C at each time point from T2 to T4, respectively (all PPP=0.033).

Conclusion: Compared with conventional sedation protocols, the ESK-DEX combined regimen demonstrated superior OI preservation immediately after procedure, enhanced OI within 24 hours postoperatively, improved…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 90 participants or records.

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