Abstract：Objective To investigate the application effect of Esketamine on neuroendoscopic resection of pituitary tumor by one-and-a-half nostril-sphenoid sinus approach. Methods A total of 98 patients who underwent neuroendoscopic resection of pituitary tumor by one-and-a-half nostril-sphenoid sinus approach from 904th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army from March 2020 to January 2022 were selected, and they were divided into study group (49 cases) and control group (49 cases) by random number table method. In study group, Esketamine 0.5 mg/kg was injected intravenously before anesthesia induction, and 0.1 mg/(kg·h) Esketamine was pumped continuously during the operation until the end of the operation; and control group was given intravenous saline in the same way. The heart rate (HR) levels of two groups were compared before anesthesia induction (T0), immediately after tracheal intubation (T1), at the end of surgery (T2), 1 h after surgery (T3) and 3 h after surgery (T4); visual analog scale (VAS) scores of T3, T4, and 6 h after surgery (T5) were compared between two groups; the dosage of Remifentanil and Propofol were compared between the two groups; the coughing degree of two groups was compared; and the occurrence of complications during recovery period was observed in the two groups. Results There was significant difference in HR between two groups at different time points within the group (P＜0.05); at T1-T4, there were statistical significances in HR between two groups (P＜0.05). The VAS scores of two groups at different time points were compared, and the difference was statistically significant (P＜0.05); at T3-T5, the VAS scores of study group were lower than those of control group, and the differences were statistically significant (P＜0.05). The dosage of Remifentanil and Propofol in study group were lower than those in control group, and the differences were statistically significant (P＜0.05). The coughing degree of study group was lower than that of control group, and the difference was statistically significant (P＜0.05). There was no significant difference in the total incidence of complications during recovery between two groups (P＞0.05). Conclusion Esketamine is effective on neuroendoscopic resection of pituitary tumor by one-and-a-half nostril-sphenoid sinus approach, maintaining hemodynamic stability, safety and reliability.
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