The Effect of Esketamine on Cough Reflex During Tracheal Extubation in Patients Undergoing Open Thyroid Surgery

After anesthesia induction, continue to administer esketamine by infusion at 0.1 mg/kg/h during the maintenance phase of anesthesia, and stop the infusion of esketamine during suturing.

After anesthesia induction, continue to administer esketamine by infusion at 0.1 mg/kg/h during the maintenance phase of anesthesia, and stop the infusion of esketamine during suturing.

After anesthetic induction, an equal amount of saline is continuously infused by pump during the maintenance phase of anesthesia, and the saline infusion is stopped during suturing;

After anesthetic induction, an equal amount of saline is continuously infused by pump during the maintenance phase of anesthesia, and the saline infusion is stopped during suturing;

2 point scales; 0=None; 0 = Did not occur; 1 = Occurred;

4 grade scales; Grade 0: No choking cough; Grade 1: Single cough episode, considered mild choking cough; Grade 2: Intermittent cough, lasting less than 5 seconds, considered moderate choking cough; Grade 3: Continuous severe cough, lasting more than 5 seconds, considered severe choking cough. The higher the degree, the worse it is.

3-level scale; 1: Awake and calm; 2: Mild agitation but can be comforted; 3: Moderate agitation, difficult to comfort; 4: Severe agitation, cannot be comforted; The higher the degree, the worse the situation.

Baseline, post-induction, 1 minute after intubation, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation

4-point scales; 0 = None; 1 = Mild, milder than a common cold; 2 = Moderate, like a sore throat from a common cold; 3 = Severe, more severe than a common cold; The higher the score, the greater the level of pain.

4-point scores; 0 = None; 1 = Transient hoarseness occurs; 2 = Patient perceives hoarseness during visit; 3 = Hoarseness is clearly noticeable; The higher the score, the more severe the hoarseness.

Pain NRS scale score: 0 = no pain; 1-3 = mild pain; 4-6 = moderate pain; 7-10 = severe pain. The higher the score, the more severe the pain.

Vomiting: 0 = None; 1 = Once; 2 = Twice; 3 = Three times or more

Nausea, does it affect daily life: 0 = None; 1 = Sometimes; 2 = Often; 3 = Always

Upper Aerodigestive Symptoms After Thyroidectomy Questionnaire; Instructions: 0=No problem, 1=Minor, 2=Moderate, 3=Major. Voice symptoms

1. Vocal fatigue

2. Difficulty speaking loudly

3. Roughness

4. Voice in low pitch

5. Can"t speak in high pitch

6. Voice in high pitch

   Swallowing/pharyngeal symptoms

7. Burning during swallowing

8. Pharyngeal bolus

9. Pain during deglutition

10. Pharyngeal pain

11. Choking

12. Dry throat

13. Discomfort during swallowing

14. Throat clearing

15. Neck scar retraction during deglutition

16. Foreign body sensation in pharynx

17. Strangling sensation during swallowing

18. Coughing during swallowing

19. Foreign body in pharynx; The higher the score, the more severe it is.

Baseline, post-induction, 1 minute after intubation, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation

Baseline, post-induction, 1 minute after intubation, during suturing, at the end of surgery, 1 minute after extubation, 5 minutes after extubation

• 4: Combative

• 3: Very agitated

• 2: Agitated

• 1: Restless 0: Alert and calm

  • 1: Drowsy
  • 2: Light sedation
  • 3: Moderate sedation
  • 4: Deep sedation
  • 5: Unarousable

4 point scores; 1 = Good sleep; 2 = Restless sleep; 3 = Dreamy sleep; 4 = Insomnia; The higher the score, the poorer the sleep.