The influence of esketamine combined with remimazolam anesthesia on postoperative sleep and recovery quality in patients with end-stage renal disease

INTERVENTION: Control Group A:The esketamine regimen was the same as that of the experimental group; remimazolam was replaced by normal saline delivered via a constant‐flow pump (an equal volume of 0.9% normal saline was infused at exactly the same time, volume, and rate), while the other sedative drugs remained the same as those in the control group.;Intervention group:5 minutes after the induction of anesthesia, 0.25 mg/kg of esketamine was injected intravenously (based on ideal body weight), followed by continuous intravenous infusion at a rate of 0.125 mg/kg until the start of wound closure; meanwhile, remimazolam was administered via target‐controlled infusion to maintain the level of sedation (BIS value of 40–60).;Control Group B:Anesthesia is maintained using sufentanil according to the standard protocol (loading dose of 0.3–0.5 g/kg, maintenance dose of 0.2–0.3 g/kg/h) in combination with propofol delivered via target‐controlled infusion (target concentration in the effect chamber of 2–4 Hg/mL).; CONDITION: End stage renal disease PRIMARY OUTCOME: Objective sleep efficiency; SECONDARY OUTCOME: Wake‐up quality;Subjective sleep quality;Postoperative delirium;Mood;Opioid consumption;Serum melatonin, cortisol levels, and inflammation markers;Overall recovery quality;Pain intensity;Adverse reactions; INCLUSION CRITERIA: 1.Age >= 18 years old; 2.Diagnosed with ESRD; 3.The planned procedure is to perform the elective PD catheterization under spinal anesthesia or general anesthesia. 4.ASA classification level II or III; 5.Sign the informed consent form;