All patients were intramuscularly injected with 1 mg of penehyclidine 30 min before surgery. Routine monitoring includes an electrocardiography, pulse oximetry, heart rate, non-invasive blood pressure, and bispectral index. The anesthesia induction and maintenance methods among the four groups were as follows: patients in group C were induced with midazolam (0.05 mg/kg), sufentanil (0.3 μg/kg), propofol (2.0 mg/kg), and rocuronium (0.8 mg/kg) and maintained with a target-controlled infusion of propofol (4–6 mg/kg/h) and remifentanil (0.2–0.6 ug/kg/min). Patients in three different doses of the S-ketamine group were induced with midazolam (0.05 mg/kg), S-ketamine (0.25, 0.5, or 0.75 mg/kg), propofol (2.0 mg/kg), and rocuronium (0.8 mg/kg) and maintained with a target-controlled infusion of propofol (4–6 mg/kg/h), remifentanil (0.2–0.6 ug/kg/min), and S-ketamine (0.25, 0.5, or 0.75 mg/kg/h).
The anesthetic administration rate was adjusted to the study protocol’s maintenance dose to maintain a bispectral index range of 40–60 and mean arterial pressure (MAP) within 20% of preoperative baseline values. Ephedrine or norepinephrine was administered if the patient had hypotension (defined as a decrease in arterial blood pressure of more than 20% of the basic value). Urapidil, alpha 1 antagonist, was administered if the patient had hypertension (defined as an increase in arterial blood pressure of more than 20% of the basic value). S-Ketamine infusion stopped 30 min before the end of surgery. Drugs possessing anti-inflammatory effects, such as dexamethasone, etomidate, lidocaine, and dexmedetomidine, were not administered during the perioperative period in all patients. Patients were transferred to the post-anesthesia care unit (PACU) for recovery.
The anesthetic administration rate was adjusted to the study protocol’s maintenance dose to maintain a bispectral index range of 40–60 and mean arterial pressure (MAP) within 20% of preoperative baseline values. Ephedrine or norepinephrine was administered if the patient had hypotension (defined as a decrease in arterial blood pressure of more than 20% of the basic value). Urapidil, alpha 1 antagonist, was administered if the patient had hypertension (defined as an increase in arterial blood pressure of more than 20% of the basic value). S-Ketamine infusion stopped 30 min before the end of surgery. Drugs possessing anti-inflammatory effects, such as dexamethasone, etomidate, lidocaine, and dexmedetomidine, were not administered during the perioperative period in all patients. Patients were transferred to the post-anesthesia care unit (PACU) for recovery.
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