Application Value of Esketamine Pre-treatment Combined with Dexmedetomidine Intravenous Anesthesia in Precision Radiotherapy for Pediatric Tumors

LI Xufei; SUN Weizhong; XU Lei

doi:10.3969/j.issn.1004-437X.2026.16.019

Abstract：Objective To investigate the application value of esketamine pre-treatment combined with dexmedetomidine intravenous anesthesia in precision radiotherapy for pediatric tumors.Methods A total of 156 children with tumors who received precision radiotherapy at the Third People's Hospital of Zhengzhou City from January 2021 to September 2024 were retrospectively enrolled.According to the anesthesia regimen,they were divided into a pre-treatment anesthesia group(78 cases)and a conventional anesthesia group(78 cases).The conventional anesthesia group received dexmedetomidine intravenous anesthesia,while the pre-treatment anesthesia group received esketamine pre-treatment combined with dexmedetomidine intravenous anesthesia.Anesthesia efficacy was compared between the two groups.Hemodynamic parameters[diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate(HR)]and anesthesia depth[University of Michigan sedation scale(UMSS)score]were recorded at four time points:before anesthesia(T0),5 min after anesthesia induction(T1),5 min after the start of radiotherapy(T2),and 5 min after radiotherapy completion(T3).Anesthesia-related indicators and adverse reactions were also compared between the two groups.Results The excellent anesthesia rate in the pre-treatment anesthesia group was higher than that in the conventional anesthesia group(P＜0.05).At T0-T3,DBP,SBP,and HR in both groups showed a trend of initial decrease followed by a gradual increase.Notably,the fluctuation magnitudes of DBP,SBP,and HR at T1 and T2 in the pre-treatment anesthesia group were smaller than those in the conventional anesthesia group(P＜0.05).The UMSS scores in both groups exhibited an initial increase followed by a decrease over T0-T3,with significantly higher scores at T,and T2 in the pre-treatment anesthesia group(P＜0.05).The onset time of anesthesia in the pre-treatment anesthesia group was shorter than that in the conventional anesthesia group(P＜0.05).However,no significant differences were observed between the two groups in total sedation time,recovery time,orientation recovery time,or the incidence of anesthesia-related adverse reactions(P＞0.05).Conclusion Esketamine pre-treatment combined with dexmedetomidine intravenous anesthesia in precision radiotherapy for pediatric tumors can better stabilize hemodynamic parameters,enhance anesthesia depth,and improve anesthesia efficacy,while also shortening the onset time.This regimen demonstrates favorable anesthesia recovery quality and a satisfactory safety profile.