Esketamine added to propofol maintains discharge readiness during outpatient flexible bronchoscopyTrial shows esketamine addition helps patients recover from bronchoscopy

Drug design, development and therapy Published June 29, 2026 Study authors: Zhang Xiaohong, Chen Lei, Chen Zaizhi, Yang Jiahan, Zheng Ting, Lin Wenjun, Guan Jinsheng, Yao Yushe… PubMed ↗ NCT05643066 ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway

Note that adding low-dose esketamine to propofol maintains timely discharge readiness for outpatient flexible bronchoscopy.

This randomized non-inferiority trial enrolled 246 adults (ASA physical status I to III) undergoing elective outpatient flexible bronchoscopy. Participants were randomized to receive either propofol alone or propofol combined with esketamine at doses of 0.1 mg/kg or 0.2 mg/kg.

The primary outcome was the proportion of patients achieving discharge readiness (MPADSS score ≥ 9) within 30 minutes of procedure completion. Results showed that both 0.1 mg/kg and 0.2 mg/kg esketamine additions were non-inferior to propofol alone, with differences of -3.0 percentage points (95% CI, -13.8 to 7.8; p = 0.003) and -5.1 percentage points (95% CI, -16.2 to 6.1; p = 0.012), respectively.

Secondary outcomes showed that esketamine addition reduced propofol consumption by 20% (0.1 mg/kg) and 28% (0.2 mg/kg) compared to propofol alone (p < 0.001). Additionally, intraoperative cough severity was significantly lower in both esketamine groups (p = 0.005 and p = 0.002, respectively).

Safety data indicated that patient-reported recovery quality was comparable across all three groups. However, exploratory findings of hypotension and hypoxemia were noted; these results are associated but not confirmed by the study design. The trial suggests adding low-dose esketamine maintains timely discharge readiness while potentially reducing propofol requirements.

How this fits prior evidence

How this fits prior evidence: This finding extends previous knowledge regarding esketamine's role in procedural settings, specifically for outpatient bronchoscopy. While previous coverage noted that an esketamine bolus reduces PPD incidence at 6 weeks to 9.15% compared to 19.33% in saline and shows fewer intraoperative adverse events than infusion, this study specifically addresses the impact of low-dose esketamine on discharge readiness and propofol consumption during bronchoscopy.

A clinical trial looked at how adding a small amount of esketamine to the standard sedative, propofol, affects patients undergoing an outpatient flexible bronchoscopy. The study included 246 adults who were scheduled for this procedure. Researchers compared those receiving propofol alone with two groups receiving propofol combined with different doses of esketamine.

The results showed that both esketamine doses were non-inferior to propofol alone when it came to being ready for discharge after the procedure. Additionally, patients who received esketamine had lower levels of coughing during the procedure and required less propofol overall. Patients reported similar recovery quality across all three groups.

While the results are promising for faster recovery, there were some safety notes to consider. The study noted instances of low blood pressure and low oxygen levels in some cases. These findings regarding safety are still exploratory and need more research to be fully understood. This trial suggests that adding esketamine could be a helpful option for certain patients during this specific procedure.

What this means for you:

Adding low-dose esketamine to propofol may reduce coughing and maintain discharge readiness during bronchoscopy.

Common questions

Does adding esketamine help with recovery?

Yes, the study found that both 0.1 mg/kg and 0.2 mg/kg doses of esketamine were non-inferior to propofol alone for discharge readiness. Patients who received esketamine also showed a reduction in cough severity during the procedure compared to those who received only propofol.

Are there any side effects to this treatment?

The study reported instances of hypotension and hypoxemia as exploratory findings. While patient-reported recovery quality was comparable across all groups, these specific safety outcomes require further confirmation before they can be fully understood.

How does it compare to standard treatment?

Patients receiving esketamine with propofol required less propofol than those receiving only propofol. The study confirmed that adding the esketamine did not negatively impact the time patients were ready to be discharged after their procedure.

Study Details

Study typeRct

Sample sizen = 82

EvidenceLevel 2

Follow-up900.0 mo

PublishedJan 2026

PMID42369372

TrialNCT05643066

View Original Abstract ↓

PURPOSE: To determine whether low-dose esketamine combined with propofol is non-inferior to propofol alone for discharge readiness after outpatient flexible bronchoscopy. PATIENTS AND METHODS: In this single-center, randomized, double-blind, non-inferiority trial, 246 adults aged 18 to 75 years with ASA physical status I to III scheduled for elective outpatient flexible bronchoscopy were randomly assigned (1:1:1) to propofol alone (propofol plus 0.9% saline; n = 82), propofol plus esketamine 0.1 mg/kg (n = 82), or propofol plus esketamine 0.2 mg/kg (n = 82). The primary endpoint was the proportion achieving discharge readiness (Modified Post-Anesthetic Discharge Scoring System [MPADSS] score ≥ 9) within 30 minutes of procedure completion; the non-inferiority margin was -18 percentage points. Secondary endpoints included propofol consumption, intraoperative cough severity, adverse events, and patient-reported recovery quality. RESULTS: Both esketamine doses were non-inferior to propofol alone for discharge readiness: the risk difference was -3.0 percentage points (95% CI, -13.8 to 7.8; = 0.003) at 0.1 mg/kg and -5.1 percentage points (95% CI, -16.2 to 6.1; = 0.012) at 0.2 mg/kg. In exploratory secondary analyses, both doses reduced propofol consumption (by 20% and 28%; both < 0.001) and intraoperative cough severity ( = 0.005 and = 0.002). Hypotension occurred in 42 (51%), 24 (29%), and 10 (12%) participants in the propofol-alone, propofol + esketamine 0.1, and propofol + esketamine 0.2 groups, respectively, and hypoxemia in 17 (21%), 10 (12%), and 3 (4%). Recovery quality was comparable across the three groups. CONCLUSION: Adding low-dose esketamine to propofol maintained timely discharge readiness during outpatient flexible bronchoscopy. Among the secondary outcomes, esketamine at 0.2 mg/kg was associated with lower rates of hypotension and hypoxemia, although these exploratory findings warrant confirmation. REGISTRATION: ClinicalTrials.gov Identifier: NCT05643066.

Esketamine added to propofol maintains discharge readiness during outpatient flexible bronchoscopyTrial shows esketamine addition helps patients recover from bronchoscopy

How this fits prior evidence

Common questions

Study Details

Primary community health care nurses improve patient outcomes and reduce costs compared to medical practitioners

Meta-analysis shows primary care nurses improve health and save money compared to medical practitioners

Clinical research that matters. Delivered to your inbox.

Esketamine added to propofol maintains discharge readiness during outpatient flexible bronchoscopyTrial shows esketamine addition helps patients recover from bronchoscopy

How this fits prior evidence

Common questions

More on propofol

Study Details

Primary community health care nurses improve patient outcomes and reduce costs compared to medical practitioners

Meta-analysis shows primary care nurses improve health and save money compared to medical practitioners

Clinical research that matters. Delivered to your inbox.

Related in Primary Care & Family Medicine

From Other Specialties