Adding esketamine to remimazolam for sedation during painless gastroscopy reduces the required dose of remimazolam and improves hemodynamic stability. In a randomized double-blind study, the median effective dose (ED50) of remimazolam alone was 0.344 mg/kg, which fell to 0.289 mg/kg with 0.2 mg/kg esketamine and to 0.193 mg/kg with 0.4 mg/kg esketamine. Patients receiving esketamine had more stable blood pressure and less hypotension, but their recovery times were significantly longer. The combination offers advantages in safety and stability for endoscopic sedation.
The material view and reductionism, which treat the external world as objective and ignore internal consciousness, have led to dilemmas in biology and physics that reveal an inseparable interaction between matter and consciousness rather than absolute opposition. Consciousness is believed to influence wave function collapse, but a scientific model is lacking. This paper proposes a holistic cognitive paradigm based on perception rather than physical characteristics, summarizing existence into two abstract contradictory perceptual states (Yin-Yang). Matter and consciousness are seen as different states of perception, unified rather than opposed. This offers a falsifiable alternative to the material view, where events are inseparable from the observer's conscious perception.