Qiu Jinpeng,Cao Huixia,Zhu Zhirui,et al.Effects of S-ketamine on emergence agitation during general anesthesia of pediatric ambulatory laparoscopy[J].Journal of Clinical Pediatric Surgery,,22():447-453.[doi:10.3760/cma.j.cn101785-202205084-009]
Effects of S-ketamine on emergence agitation during general anesthesia of pediatric ambulatory laparoscopy
- Keywords:
- Ketamine; Laparoscopes; Anesthesia; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the effects of S-ketamine on the emergence agitation during general anesthesia of pediatric ambulatory laparoscopy.Methods From March 2022 to May 2022,114 children underwent ambulatory laparoscopic hernia repair.They were randomized into two groups of S-ketamine (S) and normal saline (N) (n=57 each).Then group S received an intravenous injection of S-ketamine 0.5 mg/kg while group N had the same volume of normal saline during anesthetic induction.Noninvasive measurements of mean blood pressure (MBP) and heart rate (HR) were recorded before anesthesia (T0),after endotracheal intubation (T1),immediately after pneumoperitoneum (T2) and after surgery (T3).Also extubation time,recovery time and PACU residence time were measured.Scores of Richmond agitation and sedation scale (RASS) and Face Legs Activity Cry Consolability (FLACC) behavioral pain were recorded immediately post-extubation (T4),10 min post-extubation (T5),20 min post-extubation (T6) and 30 min post-extubation (T7).Emergence agitation(EA),severe EA,moderate to severe pain and incidence of postoperative adverse reactions were recorded.Results A total of 105 patients (group S:53,group N:52) were recruited.MBP of groups S and N was (71.90±8.76) vs.(66.55±9.51) mmHg at T1,MBP (69.52±7.21) vs.(66.55±9.51) mmHg at T2,extubation time[11.00(8.75,15.00) vs.9.50(8.00,11.00) min],recovery time[24.50(16.00,32.25) vs.12.00(8.75,18.00) min],RASS[-4(-4,-2.75) vs.-4(-4,+2)]at T4,RASS[-3(-4,-1) vs. 0(-2,+2)]at T5,RASS[-2(-3.25,0) vs. 0(-2,+1)]at T6,RASS[0(-2,+1) vs.+1(0,+1)]at T7,FLACC behavioral pain[0(0,0) vs. 0(0,5)]at T4,FLACC[0(0,0) vs. 0(0,5)]at T5,FLACC[0(0,2) vs. 0(0,3)]at T7,EA 24 cases (24/53,45.3%) vs.41 cases(41/52,78.9%),severe EA 10cases(10/53,18.9%)vs.32 cases(32/52,61.5%),moderate to severe pain 8 cases(8/53,15.1%) vs. 22 cases(22/52,42.3%), and the differences were statistically significant (P<0.05).Residence time in postanesthesia care unit (PACU) of groups S and N was[34.00(30.00,38.00) vs. 33.00(30.00,35.25) min],postoperative nausea & vomiting[(1/53,1.9%) vs. (0/52,0.0%),hypoxemia［(2/53,3.8%) vs. (1/52,1.9%)]and salivation[(1/53,1.9%) vs. (1/52,1.9%)]and the differences were not statistically significant (P>0.05).Conclusion Intravenous injection of S-ketamine 0.5 mg/kg during anesthesia induction may lower the incidence of emergence agitation during general anesthesia of pediatric ambulatory laparoscopy without a greater incidence of postoperative nausea,vomiting and hypoxemia.There is no extension of residence time in PACU.However,extubation time and recovery time become prolonged.
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Memo
收稿日期:2022-5-29。
基金项目:国家自然科学基金(81601358)
通讯作者:金海燕,Email:jinhaiyan@zju.edu.cn