To explore the safety and efficacy of esketamine combined with ciprofol in induced abortion.

A total of 100 patients who underwent induced abortion in the Civil Aviation General Hospital from January to March 2024 were selected as the research subjects, and the patients were randomly divided into two groups according to the random number table: study group (n=50, anesthetized with esketamine 0.25 mg/kg + ciprofol 0.5 mg/kg) and control group (n=50, anesthetized with sufentanil 0.1 μg/kg + ciprofol 0.5 mg/kg). The general information, anesthesia onset time, intraoperative medication, related hemodynamic indexes [mean arterial pressure (MAP) and heart rate when the patient was calm upon entering the operating room (T0), when the speculum was inserted (T1), when the cervix was dilated (T2), at the end of the surgery (T3), and upon entering the recovery room (T4)], postoperative conditions, anesthesia satisfaction and occurrence of anesthesia-related adverse reactions were recorded, and statistical comparisons were performed using independent-samples t test, repeated measures ANOVA, or chi-square tests. This study was approved by the Medical Ethics Committee of the Civil Aviation General Hospital (Approval No. 2023-L-K-04). All patients provided fully informed consent and signed the clinical research informed consent form.

①There were no statistically significant differences in general clinical data between two groups of patients, such as age, height, weight, days of amenorrhea, and operation time (P>0.05). ②The onset time of anesthesia in study group was (27.7±6.0) s, which was significantly shorter than that in control group (31.0±5.9) s, and the difference was statistically significant (t=-3.65, P<0.001). There were no significant differences in the number of intraoperative body movements, the number and dosage of intraoperative additional ciprofol, and the total dose of ciprofol (P>0.05). ③Repeated measures ANOVA of MAP and heart rate at time points T0-T4 in the two groups of patients showed that the interaction effects of different treatments and time factors were statistically significant (F_{treatment×time}=3.11, 6.17; P_{treatment×time}=0.015, 0.001), and the effects of treatments and time factors were also statistically significant (F_treatment=17.39, 11.30; F_time=64.97, 15.20; all P<0.001). Further analysis of the individual effects of treatments revealed that MAP and heart rate at time points T1-T4 in study group were significantly higher than those in control group, and the differences were statistically significant (P<0.05). ④There were no significant differences in the modified observer′s assessment of alertness/sedation scale (MOAA/S) score at the end of surgery, postoperative recovery room stay time, and the visual analogue scale (VAS) score of uterine contraction pain during the recovery period between two groups (P>0.05). There were also no statistically significant differences between two groups in anesthesia satisfaction scores and the incidence of anesthesia-related adverse reactions (P>0.05).

In induced abortion, compared with sufentanil 0.1 μg/kg combined with ciprofol, esketamine 0.25 mg/kg combined with ciprofol had a faster onset of anesthesia, comparable analgesic effect, and more stable intraoperative hemodynamics.