Clinical observation on the application of painless and non-invasive technology in induction of intravenous anesthesia for pedicatric patients
SUN Dongyan
YANG Ruchen
JIANG Xueli
ZHANG Linyu
JIAO Yuantao
Abstract：Objective To investigate the clinical effect of preoperative sedation treatment with esketamine combined with midazolam,and painless and non-invasive intravenous induction of tetracaine gel for local anesthesia.Methods A total of 120 children,including 60 toddlers(1-3 years old)and 60 preschool children(＜3-7 years old),undergoing short surgery in the inguinal region in Dali Prefea-ture Maternal and Child Health Care Hospital from September 2022 to April 2023,were selected.The toddlers and preschool children were randomly divided into the control group(n=30)and the observation group(n=30),respectively.The control group didn't receive preoperative sedation treatment,and hand cream was applied to puncture vein;a mixture of 1.5 mg/kg of esketamine injection and 0.5 mg/kg of midazolam oral solution were administrated to the observation group;vein puncture was performed under local anesthesia with tetracaine gel.The modified Yale Preoperative Anxiety Scale score(the modified Yale Preoperative Anxiety Scale,m-YPAS)immediately after the patient enters the waiting area of the operating room(T1)and immediately after entering the operating room(T2)were recorded;the situation of parent-child separation into the operating room,the acceptance of venous puncture,the induction of propofol acceptance,the restlessness after awakening,and the presence or absence of complications were observed.Results The m-YPAS score at T1 in the toddler group was significantly higher than that in the preschool children group(P＜0.05),the m-YPAS score at T2 in the control group was significantly higher than that at T1(P＜0.05),and the m-YPAS score of the toddler group and the preschool group at T2 was significantly lower than those at T1(t=3.099,4.852,P＜0.01).The acceptance of venipuncture and propofol induction in the observation group were significantly higher than those in the control group,while the scores of parent-child separation and restlessness in the recovery period in the study group were significantly lower than those in the control group(P＜0.05).Conclusion Esketamine combined with midazolam oral sedation therapy has a good anti-anxiety effect before surgery.The intravenous local anesthesia with tetracaine gel can improve the acceptability of intravenous puncture,alleviate the pain of propofol injection.These procedures helps to implement painless and non-invasive intravenous induction treatment,which is comfortable,safe and feasible.
Keywords：esketamine combined with oral midazolam for sedation before surgerytetracaine gel for local anesthesiapainless and non-invasive technologyinduction of intravenous anesthesia in children
Publication Date：2024-12-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 322-326 )