青岛大学学报（医学版）2026，Vol.62Issue(2)：208-212,5.DOI:10.11712/jms.2096-5532.2026.62.060
艾司氯胺酮对扁桃体腺样体切除病儿苏醒期躁动影响
Effect of esketamine on emergence agitation after tonsillectomy and adenoidectomy in children
摘要
Abstract
Objective To investigate the effect of preemptive analgesia with low-dose esketamine during the awakening pe-riod on emergence agitation(EA)after tonsillectomy and adenoidectomy in children.Methods A total of 52 children who under-went elective tonsillectomy and adenoidectomy under general anesthesia were enrolled and randomly divided into esketamine group(group k)and control group(group c),with 26 children in each group.The children in both groups received total intravenous anes-thesia,with penehyclidine 0.01 mg/kg,sufentanil 0.4 μg/kg,propofol 2-3 mg/kg,and rocuronium 0.6 mg/kg for induction of anesthesia and propofol 5-6 mg/(kg·h)and remifentanil 0.15-0.20 μg/(kg·min)for intraoperative maintenance of anesthesia,and all anesthetic agents were discontinued upon completion of the surgical procedure.The children in group k were given slow in-travenous injection of 0.2 mg/kg esketamine,and those in group c were given intravenous injection of 2 mL normal saline.The Pe-diatric Anesthesia Emergence Delirium(PAED)scale and the Face,Legs,Activity,Cry and Consolability(FLACC)scale were used to assess the severity of EA and pain in children.The two groups were compared in terms of the amount of analgesic and seda-tive drugs used during surgery,time to recovery of respiration,time to eye opening,extubation time,mean arterial pressure(MAP)and heart rate(HR)before anesthesia and immediately after extubation,PAED score at 10 and 20 min after extubation,FLACC score at 15 min after extubation,and other adverse reactions.Results There were no significant differences between the two groups in the amount of analgesic and sedative drugs used during surgery,time of operation,time to recovery of respiration,time to eye opening,extubation time,the length of stay in the postanesthesia care unit,MAP and HR before anesthesia,and the incidence rate of adverse reactions(P＞0.05).The children in group k had a significantly lower HR immediately after extubation,and compared with group c,The children in group k had significantly lower PAED score at 10 and 20 min after extubation,lower FLACC score at 15 min after extubation,and lower incidence rates of EA and pain(t=-3.684 to 3.195,x2=4.952,5.650,P＜0.05).Conclusion Preemptive analgesia with 0.2 mg/kg esketamine can effectively reduce the incidence rate of EA in children undergoing tonsillectomy and adenoidectomy.关键词
苏醒谵妄/艾司氯胺酮/镇痛/扁桃体切除术/腺样体切除术/儿童Key words
emergence delirium/esketamine/analgesia/ton-sillectomy/adenoidectomy/child分类
医药卫生引用本文复制引用
于潇嵘,董河..艾司氯胺酮对扁桃体腺样体切除病儿苏醒期躁动影响[J].青岛大学学报（医学版）,2026,62(2):208-212,5.基金项目
山东省卫健医疗管理研究中心科研项目(WYK-TG2023Z003) （WYK-TG2023Z003）
