Risk of esketamine anesthesia on the emergence delirium in preschool children after minor surgery: a prospective observational clinical study.
Risk of esketamine anesthesia on the emergence delirium in preschool children after minor surgery: a prospective observational clinical study.
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艾氯胺酮麻醉对学龄前儿童小手术后苏醒性谵妄的风险：一项前瞻性观察性临床研究。
DOI：
10.1007/s00406-023-01611-z
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发表时间：
2023
影响因子：
4.7
通讯作者：
Jian J. Yang
中科院分区：
文献类型：
--
作者：
Sai Chen;Jin;Yue Zhang;Lei Lei;Di Qiu;Huizhao Lv;Zhen;K. Hashimoto;Jian J. Yang
紧急谵妄（艾德）是麻醉苏醒期常见的精神并发症。然而，关于艾司氯胺酮（一种用于儿科的静脉麻醉剂）对艾德的影响的研究仍然缺乏。本研究旨在研究麻醉诱导期间艾司氯胺酮单次给药对学龄前儿童小手术后艾德的影响。共有230名儿童（2-7岁）完成了这项研究。暴露组（0.46 mg kg-1：艾司氯胺酮的平均剂量）与艾德发生率增加和最大儿科麻醉紧急谵妄评分高于非暴露组相关。暴露组的麻醉后监护室停留时间长于非暴露组。相比之下，两组的拔管时间、面部、腿部、活动、哭泣和可安慰性（FLACC）评分以及补救镇痛药的比例相当。此外，五个因素与ED相关，包括术前焦虑评分、七氟烷和丙泊酚与单用七氟烷进行麻醉维持相比、曲马多辛用于术后镇痛、FLACC评分和艾司氯胺酮暴露量。总之，用于麻醉诱导的近麻醉单次剂量艾司氯胺酮可能会增加学龄前儿童小手术后艾德的发生率。在临床实践中应注意学龄前儿童使用艾司氯胺酮进行小手术。
Emergence delirium (ED) is a common mental complication during recovery from anesthesia. However, studies on the effects of esketamine, an intravenous anesthetic for pediatrics, on ED are still lacking. This study aimed to investigate the effects of a single-dose of esketamine during anesthesia induction on ED after minor surgery in preschool children. A total of 230 children (aged 2-7 years) completed the study. The exposed group (0.46 mg kg-1: average dose of esketamine) was associated with an increased incidence of ED and a higher maximum Pediatric Anesthesia Emergence Delirium score than the non-exposed group. The length of post-anesthesia care unit stay was longer in the exposed group than the non-exposed group. In contrast, extubation time, face, legs, activity, cry, and consolability (FLACC) scores, and the proportions of rescue analgesics were comparable between the two groups. Furthermore, five factors, including preoperative anxiety scores, sevoflurane and propofol compared with sevoflurane alone for anesthesia maintenance, dezocine for postoperative analgesia, FLACC scores, and esketamine exposure, were associated with ED. In conclusion, a near-anesthetic single-dose of esketamine for anesthesia induction may increase the incidence of ED in preschool children after minor surgery. The use of esketamine in preschool children for minor surgery should be noticed during clinical practice.
影响因子：
9.8
作者：
WHITE, PF;SCHUTTLER, J;TREVOR, AJ
通讯作者：
TREVOR, AJ
影响因子：
17.7
作者：
McIntyre, Roger S.;Rosenblat, Joshua D.;Nemeroff, Charles B.;Sanacora, Gerard;Murrough, James W.;Berk, Michael;Brietzke, Elisa;Dodd, Seetal;Gorwood, Philip;Ho, Roger;Iosifescu, Dan, V;Jaramillo, Carlos Lopez;Kasper, Siegfried;Kratiuk, Kevin;Lee, Jung Goo;Lee, Yena;Lui, Leanna M. W.;Mansur, Rodrigo B.;Papakostas, George, I;Subramaniapillai, Mehala;Thase, Michael;Vieta, Eduard;Young, Allan H.;Zarate, Carlos A., Jr.;Stahl, Stephen
通讯作者：
Stahl, Stephen