Abstract: Objective To investigate the effects of low-esmketamine combined with dexmedetomidine on intra-venous analgesia, sedation in elderly patients undergoing percutaneous vertebroplasty (PVP). Methods A total of seventy-two elderly patients aged 70-90 years old who underwent PVP in Beijing Chuiyangliu hospital between March to November 2021 were enrolled in this study. Patients were assigned randomly by a random number table method into controll group (SF-DEX, n=36) and test group (ES-DEX, n=36) for the seddative analgesia anesthesia. All patients were accepted a 0.5 μg/kg dexmedetomidine by pump into venous within 10 min, the other 5 μg sufentanil was gived venously and then 0.5 μg/(kg·h) dexmedetomidine by pump in SF-DEX. 0.1 mg/kg esketamine was gived venously and then 0.1 mg/(kg·h) by pump in EK-DEX. The changes of circulatory indexes systolis arterial pressure(SAP),diastolis arterial pressure(DAP),mean arterial pressure(MAP),heart rate(HR), saturated oxygen (SpO₂), BIS indexes, pain intensity (VAS), Ramsay score for sedation level, blood pressure variation, arrhythmia and decrease range of SpO₂, were measured respectively at four time points before administration (T1), at time of operation start (T2), filling bone cement (T3), at the end of operation (T4) between two groups. Results SAP,MAP was significantly lower at T3 than that at T1 (P＜0.05) in SF-DEX; the Ramsay score was increased at T2 and T3 (P＜0.05).The VAS score in EK-DEX group was significantly lower than that in SF-DEX group at T2 and T3 (P＜0.05); the Ramsay score in EK-DEX group was significantly increased than that in SF-DEX group at T3 (P＜0.05). The incidences and hemodynamic adverse effects such as hypotension, bradycardia and desaturation, were not significantly different between the groups. Conclusions Low-dose esketamine combined with low-dose dexmedetomidine for anesthesia produces satisfactory analgesic and sedation effect in elderly patients with PVP without obvious complications. It is a safe and feasible method.

Key words: esmketamine, analgesia, sedation, elderly patients, percutaneous vertebroplasty