Adjunctive Esketamine for Analgesia in Mechanically Ventilated Septic Shock Patients

"Load dose of 0.25 mg/kg, and the fixed infusion rate of 0.15 mg/kg/h.The load dose will be injected intravenously within 1-2 minutes.Maintain the infusion at a fixed rate of 0.15 mg/kg/h for 72 hours; after 72 hours, change to a fixed rate infusion of 0.06 mg/kg/h.~Preparation: 46ml of saline + 4ml of eskeamine."

As a placebo,normal saline at the same dose as esketamine.Saline is also administered intravenously.

Remifentanil + propofol

"RASS Score:~After randomization success, a baseline Richmond Agitation-Sedation Scale (RASS) score is obtained before administering the investigational drug. Pain assessments are conducted every 1 hour within the first 6 hours after the initiation of the intravenous loading dose of the investigational drug, every 4 hours within the first 24 hours, and subsequently every 8 hours until the end of the study. In addition to the fixed time points mentioned above, researchers may conduct RASS scoring at any time based on the subject's actual condition (excessive or inadequate sedation). (No further RASS scoring is performed once the subject is fully awake.)~CPOT Score:~CPOT（Critical-Care Pain Observation Tool）Pain assessments are conducted concurrently with RASS scoring."