Effects of Esketamine on Extubation Response and Recovery Quality in Pediatric Patients with Obstructive Sleep Apnea Syndrome Undergoing Surgery

LIN Caiyun; HUANG Qingqing; CHEN Xiulan

doi:10.13919/j.issn.2095-6274.ZHJY202510024

Abstract：Objective This study investigates the effects of esketamine on extubation-induced coughing and emer-gence agitation in pediatric patients undergoing surgery for obstructive sleep apnea syndrome(OSAS).Methods A retrospective analysis was conducted on the clinical data of 89 pediatric patients with OSAS who underwent surgical treat-ment at Ningde Mindong Hospital from January 2024 to July 2025.According to the anesthesia induction protocol,the patients were divided into an observation group(esketamine group,n=45)and a control group(conventional anesthesia group,n=44).The incidence and severity of extubation-induced coughing,emergence agitation,vital signs[before anes-thesia induction(T₀),during tracheal intubation(T₁),5 minutes after surgery initiation(T₂),at extubation(T₃),and 5 min-utes after extubation(T₄)],and adverse reactions were compared between the two groups.Results Compared with the control group,the observation group exhibited a significantly lower incidence of coughing(P=0.012),reduced severity of coughing,lower incidence of agitation(P=0.014),lower PAED scores(P<0.001),and shorter duration of agitation(P<0.001).At T₀,no significant differences were observed between the two groups in heart rate(HR,P=0.775),systolic blood pressure(SBP,P=0.387),diastolic blood pressure(DBP,P=0.784),or pulse oxygen saturation(SpO₂,P=0.206).However,at T₁,T₂,T₃,and T₄,the observation group demonstrated smaller fluctuations in HR,SBP,and DBP compared to the control group(P<0.001).SpO₂ remained within the normal range at all time points in both groups,with no significant differences(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(13.33%vs 27.27%,P=0.102).Conclusion In pediatric OSAS surgery,the administration of esketamine during an-esthesia induction significantly reduces the incidence of extubation-induced coughing and emergence agitation,minimizes perioperative hemodynamic fluctuations,and demonstrates good safety.