ABSTRACT
Objective: To explore the effect of esketamine nasal drops on pain in children after tonsillectomy using low-temperature plasma ablation. Methods: 76 children who underwent tonsillectomy between May 2020 and July 2021, were randomly divided into two groups of 38 cases each. Patients in the control group were treated with conventional medication, while those in the study group were treated with esketamine nasal drops, along with the routine drug treatment. Pain levels of children in the two groups were compared within 1-3 days post-surgery, and the pseudomembrane formation and shedding-off time and recovery time were statistically analyzed. Results: The pain level of children in the study group was lower than that of the control group 1-3 days post-surgery. The pseudomembrane formation and shedding-off time and recovery time in the study group were shorter than in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups, and there were no serious adverse reactions in the two groups (P > 0.05). Conclusion: It is safe to use esketamine nasal drops in children after tonsillectomy using low temperature plasma ablation, and this is found to reduce pain and shorten the recovery time.
ABSTRACT
BACKGROUND: Adequate sedation is essential for pediatric patients undergoing 3Tesla (T) magnetic resonance imaging (MRI). Using propofol alone is associated with patient arousing and adverse airway events. This study aimed to assess esketamine vs dexmedetomidine adjunct to propofol sedation for pediatric 3 T MRI. METHODS: In this randomized, double-blind, controlled trial, 114 pediatric patients aged between 6 months and 8 years were randomly assigned, in a 1:1 ratio, to the esketamine-propofol group or the dexmedetomidine-propofol group. Sedation was provided with esketamine or dexmedetomidine in combination with propofol titration. The primary outcome was the total dose of propofol. Secondary outcomes included propofol infusion dose, adverse events, time to emergence from sedation, and time to discharge from recovery room. RESULTS: A total of 111 patients completed this study (56 in the esketamine-propofol group and 55 in the dexmedetomidine-propofol group). All MRI procedures were successfully performed under sedation. The total median (IQR) dose of propofol was significantly lower in the esketamine-propofol group (159.8 [121.7, 245.2] µg/kg/min) than that in the dexmedetomidine-propofol group (219.3 [188.6, 314.8] µg/kg/min) (difference in medians [95% CI] = - 66.9 [- 87.8 to - 43.0] µg/kg/min, P < 0.0001). The use of esketamine resulted in a lower dose of propofol for titration (difference in medians [95% CI] = - 64.3 [- 75.9 to - 51.9] µg/kg/min), a shorter time to emergence (difference in means [95% CI] = - 9.4 [- 11.4 to - 7.4] min), and a reduced time to recovery room discharge (difference in means [95% CI] = - 10.1 [- 12.1 to - 8.2] min). In the dexmedetomidine-propofol group, 2 patients experienced upper airway obstruction and 6 patients had bradycardia. No episodes of oxygen desaturation or other adverse events were observed. CONCLUSIONS: Although both regimens provided effective sedation for pediatric 3 T MRI, the esketamine-propofol sedation reduced propofol requirement and facilitated recovery, without detection of increased adverse effects in the studied population. Trial registration Chinese Clinical Trial Registry (identifier: ChiCTR2100048477).
