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Low-dose esketamine for the prevention of emergency agitation in children after tonsillectomy: A randomized

Qi Li1, Jiaming Fan2, Wangping Zhang2

  • 1Department of Anesthesiology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China.

Frontiers in Pharmacology
|January 6, 2023
PubMed

Insights

Low-dose esketamine significantly reduced emergency agitation in children after tonsillectomy. This intervention did not prolong extubation or increase side effects, offering a safe option for pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Emergency agitation is a frequent postoperative complication in children undergoing general anesthesia.
  • Tonsillectomy is a common pediatric surgical procedure where this complication is observed.

Purpose of the Study:

  • To investigate the efficacy of a low dose of esketamine in mitigating emergency agitation in pediatric patients post-tonsillectomy.
  • To evaluate the safety profile of low-dose esketamine in this patient population.

Main Methods:

  • A prospective study involving 80 children undergoing tonsillectomy, randomized into esketamine and control groups.
  • Standardized anesthesia protocols were used; the esketamine group received 0.25 μg/kg esketamine post-surgery.
  • Key metrics included extubation time, eye-opening time, Ramsay sedation scale, PACU discharge time, and postoperative complications.

Main Results:

  • The incidence of emergency agitation was significantly lower in the esketamine group (5%) compared to the control group (27.5%).
  • Eye-opening time was slightly prolonged in the esketamine group (17.2 min vs. 15.5 min).
  • Extubation time and PACU discharge time remained comparable between groups, with no increase in other adverse events.

Conclusions:

  • Low-dose esketamine effectively reduces emergency agitation in children after tonsillectomy.
  • This intervention is safe and does not negatively impact recovery times or increase other postoperative complications.

Keywords:
childrenemergency agitationesketaminegeneral anesthesiatonsillectomy

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