Effect of different esketamine administration regimens in the treatment of preschool children undergoing ambulatory urologic surgery

YANG Liang; DENG Lian; QI Dongmei; CHEN Xiangnan; LI Kunwei; SUN Yijuan

doi:10.3969/j.issn.2096-2681.2024.02.001

Abstract：Objective To investigate the effects of different esketamine administration regimens on anesthetic management and postop-erative pain in preschool children undergoing ambulatory urologic surgery.Methods Sixty children aged 2 to 6 years old,ASA class Ⅰ orⅡ,scheduled for elective ambulatory urologic surgery under general anesthesia with tracheal intubation from June 2022 to January 2023 in our hospital,were selected and divided into control group(group C,n=20);esketamine 0.3 mg/kg group(group MK,n=20);and esketamine 0.5 mg/kg group(group HK,n=20)according to random number table method.Intraoperative anesthesia was maintained by inhalation of 1.3 MAC sevoflurane,and HR and MAP were recorded after admission to the room(T0),3 min after induction of anesthesia(T1),at the time of surgical skin incision(T2),10 min after the start of surgery(T3),and at the time of removal of the laryngeal mask(T4).The anesthesia time,operation duration,anesthesia withdrawal time,and resuscitation room stay time were recorded.The pain scores and sedation scores at 5 min(T5),1 h(T6)and 24 h(T7)after removal of the laryngeal mask were recorded,the occurrence of postoperative adverse reactions was recorded,and the additional number and doses of sufentanil intraoperatively as well as in the PACU were recorded.Results At T1,MAP in group MK and group HK were statistically significant compared with those in group C(P＜0.05);at T5 and T6,the analgesic scores in group MK and HK were lower than those in group C(P＜0.05);the sedation scores in group HK were higher than those in group C and group MK(P＜0.05);the additional doses of sufentanil in group MK and HK were less than those in group C intraoperatively and in the PACU(P＜0.05);compared with group C and group MK,the extraction time and the length of stay in the PACU were significantly longer than that in group HK(P＜0.05);the incidence of postoperative dizziness in group HK was higher than that in group C and group MK(P＜0.05);as for the number of additional doses of sufentanil,group C was significantly higher than that of group MK and HK(P＜0.05).Conclusion The intravenous induction of esketamine 0.3 mg/kg can reduce the dose of sufentanil in preschool children undergoing ambulatory urologic surgery and maintain a more stable hemodynamic level,reduce intraop-erative and postoperative pain,and obtain a more satisfactory sedation effect without increasing the length of extubation and resuscitation,and postoperative adverse effects.