Intranasal Dexmedetomidine Combined With Esketamine for Emergence Quality After Suspension Laryngoscopy

This is a single-center, prospective, single-blinded, randomized controlled trial conducted at The First Hospital of Jilin University. A total of 134 adult patients aged 18-65 years with ASA Ⅰ-Ⅲ undergoing elective laryngoscopic surgery for vocal cord polyps will be enrolled. Subjects will be randomly assigned into two groups. The control group receives intranasal dexmedetomidine plus intravenous normal saline before anesthesia induction. The combination group receives the same dose of intranasal dexmedetomidine plus intravenous esketamine before induction. The primary objective is to compare the incidence of emergence agitation within 60 minutes after extubation. Secondary outcomes include hemodynamic changes, adverse events, recovery time, PACU stay, postoperative sore throat pain and quality of recovery at 24 hours. Standardized anesthesia induction and maintenance will be applied for all patients. The study aims to explore whether the combination of intranasal dexmedetomidine and esketamine improves recovery quality in patients undergoing suspension laryngoscopy.

Inclusion Criteria: * 1\. Aged 18-65 years, male or female. 2. ASA physical status Ⅰ or Ⅱ. 3. Scheduled for elective surgery under general anesthesia with tracheal intubation. 4\. Expected operation duration 30-180 minutes. 5. Able to understand the study content and sign written informed consent voluntarily. Exclusion Criteria: * 1\. Preoperative cognitive dysfunction or psychiatric disorders. 2. Known allergy to dexmedetomidine or esketamine. 3. Severe cardiac, respiratory, hepatic or renal insufficiency. 4. Predicted difficult airway. 5. Drug abuse or long-term use of sedatives. 6. Pregnant or breastfeeding women.