Efficacy of esketamine combined with propofol for colonic transendoscopic enteral tubing in pediatric patients with autism
10.3760/cma.j.cn131073.20230915.00112
- VernacularTitle:艾司氯胺酮复合丙泊酚用于孤独症患儿内镜肠道植管术麻醉的效果
- Author:
Yanxiang MIAO
1
;
Minghui ZHENG
;
Jinxiang FENG
;
Qing LI
;
Ning YIN
;
Faming ZHANG
Author Information
1. 南京医科大学附属逸夫医院麻醉科，南京 211112
- Keywords:
Ketamine;
Propofol;
Autism spectrum disorder;
Children;
Colonoscopy;
Fecal microbiota transplantation;
Transendoscopic enteral tubing
- From:
Chinese Journal of Anesthesiology
2024;44(1):58-62
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of esketamine combined with propofol for colonic transendoscopic enteral tubing (TET) in pediatric patients with autism.Methods:Sixty pediatric patients with autism of both sexes, aged 3-12 yr, weighing 15-45 kg, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent painless transendoscopic enteral tubing (TET) from October 2022 to August 2023, were selected and divided into 2 groups ( n=30 each) by a random number table method: normal saline + propofol group (group NP) and esketamine + propofol group (group EP). In group NP, normal saline 10 ml was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. In group EP, esketamine 0.3 mg/kg (diluted to 10 ml in normal saline) was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. TET was performed when the Modified Observer′s Assessment of Alertness/Sedation Scale score ≤2. Propofol 0.5-1.0 mg/kg was added if the sedation depth was not enough, and the Modified Observer′s Assessment of Alertness/Sedation Scale score was maintained ≤2 until the end of surgery. The degree of body movement during TET was observed and recorded. The injection pain during induction, total consumption of propofol, operation time, spontaneous emergence time, and completion of operation were recorded. Adverse reactions such as respiratory depression, nausea and vomiting, hypotension, bradycardia, and postoperative agitation were recorded during operation and in the emergence period. Results:Compared with group NP, the degree of intraoperative body movement was significantly lighter, the total consumption of propofol and incidence of injection pain and intraoperative hypotension were significantly lower, and no significant change was found in the spontaneous emergence time and incidence of adverse reactions during recovery in group EP ( P<0.05). Conclusions:Esketamine (0.3 mg/kg) combined with propofol (2.0 mg/kg) can be safely and effectively used for colonic TET in pediatric patients with autism, and esketamine does not increase the risk of adverse reactions during resuscitation in a resuscitation strategy without early awakening.
