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Open Access 01-12-2024 | Esketamine | Research

Effectiveness of perioperative low-dose esketamine infusion for postoperative pain management in pediatric urological surgery: a prospective clinical trial

Authors: Yanle Xie, Zenghui Liang, Shuhan Chen, Jing Liu, Huimin lv, Fei Xing, Yuanyuan Mao, Yanling Ren, Xin Wei, Zhongyu Wang, Na Xing, Jianjun Yang, Xiyao Gu, Jingjing Yuan

Published in: BMC Anesthesiology | Issue 1/2024

Abstract

Background

Postoperative pain is common in pediatric urological surgery. The study assess the impact of perioperative intravenous infusion of low-dose esketamine on postoperative pain in pediatric urological surgery.

Methods

Pediatric patients (n = 80) undergoing urological surgery were randomized into four groups. Patients in the control group were administered an analgesic pump containing only hydromorphone at a dose of 0.1 mg/kg (Hydromorphone Group 1, H1) or 0.15 mg/kg (Hydromorphone Group 2, H2). Patients in the experimental group were injected intravenously with 0.3 mg/kg of esketamine (Esketamine group 1, ES1) or equal volume of saline (Esketamine Group 2, ES2) during anesthesia induction. Esketamine 1.0 mg/kg and hydromorphone 0.1 mg/kg were added to the analgesic pump. Face, Leg, Activity, Crying, and Comfort (FLACC) scale or the Numerical Rating Scale (NRS) and adverse effects were recorded at 2, 6, 24, and 48 h postoperatively. Additionally, total and effective PCA button presses were recorded.

Results

In comparison to the H1 group, the pain scores were notably reduced at all postoperative time points in both the ES1 and H2 groups. The ES2 group exhibited lower pain scores only at 24 and 48 h postoperatively. When compared to the H2 group, there were no significant differences in pain scores at various postoperative time points in the ES2 group. However, the ES1 group demonstrated significantly lower pain scores at 6, 24 and 48 h postoperatively, and these scores were also significantly lower than those observed in the ES2 group. The total and effective number of PCA button presses in the ES1, ES2 and H2 group were lower than that in the H1 group (P < 0.001). The incidence of adverse effects within 48 h after surgery was 15% in ES1, 22% in ES2, 58% in H1, and 42% in H2, respectively (P = 0.021).

Conclusions

The use of low-dose esketamine infusion in analgesia pump can effectively alleviates postoperative pain in pediatric urological patients, leading to a significant reduction in the number of analgesic pump button press. The combined approach of perioperative anesthesia induction and analgesia pump administration is recommended for optimal pain management in these patients.

Trial registration

Chinese Clinical Trial Registry- ChiCTR2300073879 (24/07/2023).

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Title: Effectiveness of perioperative low-dose esketamine infusion for postoperative pain management in pediatric urological surgery: a prospective clinical trial
Authors: Yanle Xie
Zenghui Liang
Shuhan Chen
Jing Liu
Huimin lv
Fei Xing
Yuanyuan Mao
Yanling Ren
Xin Wei
Zhongyu Wang
Na Xing
Jianjun Yang
Xiyao Gu
Jingjing Yuan
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Esketamine
Esketamin
Hydromorphone
Urological Surgery
Urological Surgery
Pediatric Urology
Pediatric Urology
Postoperative Pain Management
Published in: BMC Anesthesiology / Issue 1/2024
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-024-02450-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of perioperative low-dose esketamine infusion for postoperative pain management in pediatric urological surgery: a prospective clinical trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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