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Effects of esketamine combined with ultrasound-guided nerve block on cognitive function in children with lower
1Department of Anesthesiology, The First Affiliated Hospital of Hainan Medical College Haikou 570102, Hainan Province, China.
Insights
Esketamine combined with ultrasound-guided nerve block offers a safer anesthetic option for pediatric lower extremity fractures, significantly reducing complications compared to general anesthesia. This approach demonstrates superior outcomes for children undergoing fracture repair.
Area of Science:
- Anesthesiology
- Pediatric Orthopedics
- Regional Anesthesia
Background:
- Pediatric lower extremity fractures require effective pain management and anesthesia.
- General anesthesia can be associated with significant physiological stress and complications in children.
- Ultrasound-guided nerve blocks offer targeted anesthesia but may require adjuncts for optimal outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of esketamine combined with ultrasound-guided nerve block for pediatric lower extremity fractures.
- To compare this combined approach with ultrasound-guided nerve block plus general anesthesia.
- To assess the impact on physiological parameters and complication rates.
Main Methods:
- A comparative study involving 120 children with lower extremity fractures.
- Observation group (OG): Esketamine + ultrasound-guided nerve block.
- Control group (CG): Ultrasound-guided nerve block + general anesthesia.
- Monitoring of hemodynamic and respiratory parameters, serum stress hormones, and complication incidence.
- Evaluation of cognitive function using the mini-mental state examination (MMES) scale.
Main Results:
- The esketamine combination group (OG) exhibited lower mean arterial pressure (MAP) and heart rate (HR) at 10 and 20 minutes post-anesthesia compared to the general anesthesia group (CG).
- Post-surgery, serum norepinephrine (NE), epinephrine (E), and renin (R) levels were significantly lower in the OG than in the CG.
- The OG demonstrated a significantly lower complication rate (8.33%) compared to the CG (20.00%).
Conclusions:
- Esketamine combined with ultrasound-guided nerve block provides superior anesthetic effects and a significantly lower complication rate in children with lower extremity fractures.
- This combination represents a safer and more effective anesthetic strategy for pediatric orthopedic surgery.
- The findings support the use of esketamine-based regional anesthesia to mitigate physiological stress in pediatric patients.
Objective:
To explore the effect and complications of esketamine combined with ultrasound-guided nerve block in children with lower extremity fractures.
Methods:
120 children with fractures of lower extremities were included into the observation group (OG) and control group (CG) according to the specific anesthesia method. The OG was given esketamine combined with ultrasound-guided nerve block, and the CG was given ultrasound-guided nerve block combined with general anesthesia. Serum norepinephrine (NE), epinephrine (E), renin (R), mean arterial pressure (MAP), heart rate (HR), oxyhemoglobin saturation (SpO2) and respiration rate (RR) were measured before, at 10, 20, and 30 min after anesthesia. The incidence of clinical complications and the anesthetic effects were compared between the two groups. The mini-mental state examination (MMES) scale was performed to evaluate the cognitive function of children in the two groups before and after surgery.
Results:
At 10 min and 20 min after anesthesia, the CG showed higher MAP and HR than the OG (P<0.05); however, RR and SpO2 showed no difference between the two groups (P>0.05). At 30 min after anesthesia, HR and MAP were not significantly different between the two groups (P>0.05); NE, E, and R showed no significant difference before surgery (P>0.05), which were higher in CG than those in the OG after surgery (P<0.05). The success rate of nerve block and anesthesia were 91.67% and 85.00%, respectively in the OG, which were higher than 88.33% and 83.33% in the CG (P>0.05). The OG had a complication rate of 8.33%, significantly lower than that of 20.00% in the CG (P<0.05).
Conclusion:
Esketamine combined with ultrasound-guided nerve block anesthesia was superior to ultrasound-guided nerve block combined with general anesthesia in children with lower extremity fractures, with fewer compilations.
