Esketamine-propofol Versus Propofol for Flexible Bronchoscopy

Summary

Bronchoscopy is a promising technology for lung and bronchus disease detection and therapy. However, this procedure is associated with a relatively high risk of hypoxemia, coughing, wheezing, and dyspnea. Despite the fact that propofol is the most commonly used agent in procedure sedation, the narrow therapeutic index remains challenging. Esketamine is the s-enantiomer of ketamine with potent analgesic and sedative properties. This study aims to test the hypothesis that adding subanesthetic esketamine to propofol is non-inferior to propofol alone for bronchoscopy on the recovery profile and discharge from the hospital.

Timeline

Start

2022-12-07

Primary completion

2023-12-18

Completion

2023-12-21

Outcome

Met primary endpoint

paper Both esketamine doses were non-inferior to propofol alone for discharge readiness: PMID 42369372 ↗

paper the risk difference was -3.0 percentage points (95% CI, -13.8 to 7.8; P non-inferiority = 0.003) at 0.1 mg/kg PMID 42369372 ↗

paper -5.1 percentage points (95% CI, -16.2 to 6.1; P non-inferiority = 0.012) at 0.2 mg/kg. PMID 42369372 ↗

Publications

• Zhang X, Chen L, Chen Z, Yang J, Zheng T, Lin W, Guan J, Yao Y. Discharge Readiness After Propofol with or without Esketamine for Flexible Bronchoscopy: A Randomized Non-Inferiority Trial. Drug Des Devel Ther. 2026 Jun 22;20:612153. doi: 10.2147/DDDT.S612153. eCollection 2026.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Esketamine	Other / unclassified	0.1 mg/kg	Intravenous
Subject	Esketamine	Other / unclassified	0.2 mg/kg	Intravenous
Subject	Propofol	Small molecule	0.5 mg/kg	Intravenous

Indications

No indication recorded.