The effect of esketamine combined with dexmedetomidine on children undergoing tonsillectomy
LU Guangtao1, CHEN Jian2, ZHOU Zhili1, QIAN Jiashu1, LIN Xuezheng1
1.Department of Anesthesiology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou 318000, China; 2.Department of Anesthesiology, Taizhou Hospital, Taizhou 317000, China
LU Guangtao,CHEN Jian,ZHOU Zhili, et al. The effect of esketamine combined with dexmedetomidine on children undergoing tonsillectomy[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(11): 881-884.
Abstract：Objective: To investigate the effect of pretreatment with esketamine+dexmedetomidine (DEX) on hemodynamics and emergence agitation (EA) in children undergoing tonsillectomy. Methods: Eighty children from February to December 2020 (ASA class I~II, aged 5 to 13 years) underwent tonsillectomy in Taizhou Central Hospital were randomly divided as group E and group ED, with 40 cases each. Before anesthesia induction,children in group E received esketamine 0.5 mg/kg, while those in group ED received equal volume (10 mL) of esketamine 0.5 mg/kg+DEX 1.0 μg/kg. Pediatric anesthesia emergence delirium (PAED) and face, legs, activity,cry, consolability (FLACC) scales were used to score the EA and pain within 30 min after entering the postanesthetic care unit (PACU). Heart rate (HR) and mean arterial pressure (MAP) were recorded before anesthesia(T0), when extubation (T1), 5 min (T2) and 10 min (T3) after extubation. Operation time, emergence time, PACU residence time, and adverse reactions were also recorded. Results: There was no statistically difference in FLACC scores between the two groups (P>0.05). The PAED score of group ED was significantly lower than that of group E (P<0.05). There were no significant differences in MAP and HR between the two groups at T0, T3,however, HR and MAP in group ED at T1 and T2 were lower than in group E (P<0.05). There were no significant differences in the operation time, emergence time and PACU residence time between the two groups (P>0.05).The incidence of adverse reactions such as dizziness, nausea and vomiting in group ED was obviously lower than in group E (P<0.05). Conclusion: The application of esketamine combined with DEX in children undergoing tonsillectomy can effectively reduce the incidence of emergence agitation, improve hemodynamic stability and decrease adverse reactions, which is of remarkable clinical significance.
