Median effective dose of esketamine for preoperative sedation in pediatric patients of different ages
10.3760/cma.j.cn131073.20211212.00315
- VernacularTitle:艾司氯胺酮用于不同年龄段患儿术前镇静的半数有效剂量
- Author:
Beibei ZHANG
1
;
Yitian YANG
;
Jia JIA
;
Fanmin MENG
;
Jiaqiang ZHANG
Author Information
1. 河南省人民医院（郑州大学人民医院）麻醉与围术期医学科，郑州 450003
- Keywords:
Ketamine;
Child;
Dose-response relationship, drug;
Conscious sedation;
Preoperative care
- From:
Chinese Journal of Anesthesiology
2022;42(3):320-322
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the median effective dose (ED 50) of esketamine for preoperative sedation in different aged pediatric patients. Methods:Pediatric patients, aged 1-6 yr, of American Society of Anaesthesiologists physical status Ⅰ, with the preoperative parental Separation Anxiety Scale (PSAS) score ≥3, undergoing elective surgery under general anesthesia, were selected.According to the age, the children were divided into 1 yr≤age<4 yr low-age group (group L) and 4 yr≤age< 6 yr high-age group (group H). Esketamine 0.5 mg/kg was intravenously injected in the first child in each group.The dose in the next child was determined according to PSAS scores, and the two consecutive dose gradient was 0.1 mg/kg; when the PSAS score in the previous child was ≥3, the dose in the next child was increased; when the PSAS score in the previous child was< 3, the dose in the next child was decreased until appearance of 7 turning points, and then the experiment was terminated.The ED 50 and 95% confidence interval of esketamine for preoperative sedation were calculated by probit analysis. Results:A total of 54 children were enrolled in this study, including 26 cases in group L and 28 cases in group H. The ED 50 and 95% confidence interval of esketamine were 0.413 (0.314-0.530) mg/kg and 0.282 (0.252-0.318) mg/kg in group L and group H, respectively.Compared with group L, ED 50 of esketamine was significantly decreased in group H ( P<0.05). Conclusions:The ED 50 of esketamine for preoperative sedation is 0.413 mg/kg in pediatric patients of 1 yr≤age<4 yr old and 0.282 mg/kg in those of 4 yr≤age<6 yr old, and the efficacy of esketamine for preoperative sedation increases with age.
