Application and safety of low-dose esketamine in children undergoing tonsillectomy and adenoidectomy
Objective To explore the application effectiveness of low-dose esketamine in the treatment of children undergoing tonsillectomy and adenoidectomy,and perform safety analysis.Methods A total of 298 children with tonsil and adenoid hypertrophy admitted to Lishui People'.s Hospital were retrospectively selected from September 2023 to December 2023.All the children received tonsillectomy and adenoidectomy and general anesthesia.According to the condition of children and the voluntary principle of the parents,they were divided into a study group(n=150)and a control group(n=148).The study group was treated with low-dose esketamine combined with general anesthesia,with 0.2-0.3 mg/kg intravenous injection,followed by 0.2 mg·kg-1·h-1 intrave-nous infusion anesthesia maintenance;the control group was treated with an equal amount of normal saline.Other drugs used for anesthesia induction and maintenance were the same in the two groups.There were 125 patients in each group after the confounding factors were excluded by propensity matching score.The mean arterial pressure(MAP)and heart rate(HR)before anesthesia,at 5 min after induction,at the time of tracheal intubation,at 10 min after the start of surgery and at the end of surgery,Face,Legs,Activity,Crying,Consolability(FLACC)score and Pediatric Anesthesia Emergence Delirium(PAED)score at 10 min and 30 min after entering the postanesthesia care unit(PACU),surgery-related indicators,anesthetic drug use and postoperative adverse reactions were com-pared between groups.Results There were no statistically statistical differences in MAP and HR at different time points during the perioperative period in study group(P＞0.05).At 5 min after induction,tracheal intubation and 10 min after the start of surgery,the MAP and HR in control group were declined than those before anesthesia,and were lower than those in study group(P＜0.05).The FLACC score and PAED score in study group at 10 min and 30 min after entering the PACU were lower than those in control group(P＜0.05).Compared with control group,the dosage of intraoperative remifentanil and the number of cases with additional propofol during recovery in study group were less,and the PACU stay was shorter(P＜0.05).The total incidence rate of adverse reactions in study group was lower than that in control group(P＜0.05).Conclusion Low-dose esketamine has significant ap-plication effectiveness during tonsillectomy and adenoidectomy in children.Without affecting the recovery of surgery,it can maintain the hemodynamic stability of children,relieve the pain,and reduce the occurrence of EA and the dosage of anesthetic drug,and it has safety and clinical application value.
万方数据
维普
