Preventive effect of a subanesthetic dose of esketamine on emergence agitation in pediatric patients undergoing fracture fixation surgery under general anesthesia
10.3760/cma.j.cn131073-20240805-00707
- VernacularTitle:亚麻醉剂量艾司氯胺酮对骨折固定术患儿苏醒期躁动的预防效果
- Author:
Fangfang YANG
1
;
Meichao WU
1
;
Liang ZHAO
1
;
Qiufeng WANG
1
;
Chenxu DAI
1
;
Xingjun MA
1
;
Ning CAI
1
Author Information
1. 阜阳市人民医院麻醉科，阜阳 236000
- Publication Type:Journal Article
- Keywords:
Ketamine;
Emergence delirium;
Child;
Fracture fixation
- From:
Chinese Journal of Anesthesiology
2025;45(7):818-822
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the preventive effect of a subanesthetic dose of esketamine on emergence agitation (EA) in pediatric patients undergoing fracture fixation surgery under general anesthesia.Methods:This study was a randomized, double-blind, placebo-controlled trial. Eighty-two pediatric patients, aged 3-6 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective closed reduction and internal fixation of humeral fractures at the People′s Hospital of Fuyang City from March 2023 to August 2024, were divided into 2 groups ( n=41 each) using simple random sampling: esketamine group (group E) and control group (group C). Group E received an intravenous injection of esketamine at a dose of 0.3 mg/kg before anesthesia induction, while the equal volume of normal saline was given instead in group C. The induction and maintenance of general anesthesia were the same in both groups. The drug was discontinued after operation and the children were transferred to the post-anesthesia care unit. The primary outcome was the occurrence of EA assessed using the Pediatric Anesthesia Emergence Delirium scale. Secondary outcome measures included the acceptance of the facemask during anesthesia induction, the rate of propofol use during the emergence period, the Children′s Hospital of Eastern Ontario Pain Scale scores at awakening and at 2 and 6 h postoperatively, the requirement for rescue analgesia in the emergence period, and the occurrence of adverse reactions. Results:Compared with group C, the incidence of EA [38% (15/39) vs. 15% (6/40)] was significantly decreased, the usage rate of propofol during the emergence period was decreased, the degree of acceptance of the facemask during anesthesia induction was increased, and Children′s Hospital of Eastern Ontario Pain Scale scores at all time points and the rate of rescue analgesia in the emergence period were decreased in group E ( P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:Administering a subanesthetic dose of esketamine before anesthesia induction can reduce the risk of EA in pediatric patients undergoing fracture fixation surgery under general anesthesia and raise the the quality of recovery with a high safety.
