Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias
ObjectiveTo explore the safety and efficacy of the combination of continuous intravenous infusion of esketamine with sacral block for postoperative analgesia in pediatric patients undergoing surgery for hypospadiasMethodsPediatric patients (n = 77) undergoing surgery for hypospadias were randomized...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1131137/full |
| _version_ | 1797852937331933184 |
|---|---|
| author | Yong Xu Yong Xu Quan Chen Ping Li Xingrong Song Xingrong Song |
| author_facet | Yong Xu Yong Xu Quan Chen Ping Li Xingrong Song Xingrong Song |
| author_sort | Yong Xu |
| collection | DOAJ |
| description | ObjectiveTo explore the safety and efficacy of the combination of continuous intravenous infusion of esketamine with sacral block for postoperative analgesia in pediatric patients undergoing surgery for hypospadiasMethodsPediatric patients (n = 77) undergoing surgery for hypospadias were randomized into two groups: a hydromorphone group (H group, initial dose, 0.02 mg/kg; maintenance dose, 0.01 mg/kg/h) or an esketamine group (E group, initial dose, 0.3 mg/kg; maintenance dose 0.15 mg/kg/h). Caudal epidural block involved injection of 0.2% ropivacaine 1 ml/kg through the sacral hiatus. Age, weight, grade of hypospadias, intraoperative blood loss, operative time, and awaking time of patients were recorded. The Face, Legs, Activity, Cry and Consolability (FLACC) scale and Ramsay sedation scores were recorded when leaving the PACU (0 h) and at postoperative 2, 6, 12, 24, 36, and 48 h. The Pediatric Anesthesia Emergence Delirium Scale (PAED), incidence of hypotension, respiratory depression, nausea and vomiting and pruritus, and the time to first bowel movement after surgery were recorded.ResultsThere were no significant differences in demographic and clinical characteristics between the H group and the E group. There were no significant differences in FLACC scores at postoperative 0, 2, 6, 12, 24, 36, and 48 h in intra-group and inter-group comparisons. There were no significant differences in Ramsay sedation scores at postoperative 0, 2, 6, 12, 24, 36, and 48 h in the intra-group comparisons. Ramsay sedation scores were significantly lower at postoperative 2, 12, and 36 h in the H group compared to the E group. There were no significant differences in the PAED scale or incidence of nausea and vomiting or pruritus between the H group and the E group. The incidence of hypotension and respiratory depression was significantly lower, and the time to first bowel movement was significantly shorter in the E group compared to the H group. Urinary tryptophan, 5-hydroxytryptamine and substance P levels were significantly lower but arginine was significantly higher in the E group compared to the H group.ConclusionsThe combination of continuous intravenous infusion of esketamine with sacral block provided safe and effective postoperative analgesia for pediatric patients undergoing surgery for hypospadias.Trial registrationChinese Clinical Trial Register ChiCTR2200066967. Clinical trial registry URL: http://www.chictr.org.cn/edit.aspx?pid=185042&htm=4 |
| first_indexed | 2024-04-09T19:42:24Z |
| format | Article |
| id | doaj.art-b3491fcaea6d4c2e8b5529247f3f2e8c |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-09T19:42:24Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-b3491fcaea6d4c2e8b5529247f3f2e8c2023-04-04T05:11:46ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-04-011010.3389/fsurg.2023.11311371131137Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadiasYong Xu0Yong Xu1Quan Chen2Ping Li3Xingrong Song4Xingrong Song5Department of Anesthesiology, The First School of Clinical Medicine of Jinan University, Guangzhou, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, ChinaDepartment of Anesthesiology, The First School of Clinical Medicine of Jinan University, Guangzhou, ChinaDepartment of Anesthesiology, Guangzhou Women and Children’s Medical Center, Guangzhou, ChinaObjectiveTo explore the safety and efficacy of the combination of continuous intravenous infusion of esketamine with sacral block for postoperative analgesia in pediatric patients undergoing surgery for hypospadiasMethodsPediatric patients (n = 77) undergoing surgery for hypospadias were randomized into two groups: a hydromorphone group (H group, initial dose, 0.02 mg/kg; maintenance dose, 0.01 mg/kg/h) or an esketamine group (E group, initial dose, 0.3 mg/kg; maintenance dose 0.15 mg/kg/h). Caudal epidural block involved injection of 0.2% ropivacaine 1 ml/kg through the sacral hiatus. Age, weight, grade of hypospadias, intraoperative blood loss, operative time, and awaking time of patients were recorded. The Face, Legs, Activity, Cry and Consolability (FLACC) scale and Ramsay sedation scores were recorded when leaving the PACU (0 h) and at postoperative 2, 6, 12, 24, 36, and 48 h. The Pediatric Anesthesia Emergence Delirium Scale (PAED), incidence of hypotension, respiratory depression, nausea and vomiting and pruritus, and the time to first bowel movement after surgery were recorded.ResultsThere were no significant differences in demographic and clinical characteristics between the H group and the E group. There were no significant differences in FLACC scores at postoperative 0, 2, 6, 12, 24, 36, and 48 h in intra-group and inter-group comparisons. There were no significant differences in Ramsay sedation scores at postoperative 0, 2, 6, 12, 24, 36, and 48 h in the intra-group comparisons. Ramsay sedation scores were significantly lower at postoperative 2, 12, and 36 h in the H group compared to the E group. There were no significant differences in the PAED scale or incidence of nausea and vomiting or pruritus between the H group and the E group. The incidence of hypotension and respiratory depression was significantly lower, and the time to first bowel movement was significantly shorter in the E group compared to the H group. Urinary tryptophan, 5-hydroxytryptamine and substance P levels were significantly lower but arginine was significantly higher in the E group compared to the H group.ConclusionsThe combination of continuous intravenous infusion of esketamine with sacral block provided safe and effective postoperative analgesia for pediatric patients undergoing surgery for hypospadias.Trial registrationChinese Clinical Trial Register ChiCTR2200066967. Clinical trial registry URL: http://www.chictr.org.cn/edit.aspx?pid=185042&htm=4https://www.frontiersin.org/articles/10.3389/fsurg.2023.1131137/fullesketaminepostoperative analgesiapediatrichypospadiasopioids |
| spellingShingle | Yong Xu Yong Xu Quan Chen Ping Li Xingrong Song Xingrong Song Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias Frontiers in Surgery esketamine postoperative analgesia pediatric hypospadias opioids |
| title | Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias |
| title_full | Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias |
| title_fullStr | Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias |
| title_full_unstemmed | Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias |
| title_short | Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias |
| title_sort | safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias |
| topic | esketamine postoperative analgesia pediatric hypospadias opioids |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1131137/full |
| work_keys_str_mv | AT yongxu safetyandefficacyofesketamineforpostoperativeanalgesiainpediatricpatientswithhypospadias AT yongxu safetyandefficacyofesketamineforpostoperativeanalgesiainpediatricpatientswithhypospadias AT quanchen safetyandefficacyofesketamineforpostoperativeanalgesiainpediatricpatientswithhypospadias AT pingli safetyandefficacyofesketamineforpostoperativeanalgesiainpediatricpatientswithhypospadias AT xingrongsong safetyandefficacyofesketamineforpostoperativeanalgesiainpediatricpatientswithhypospadias AT xingrongsong safetyandefficacyofesketamineforpostoperativeanalgesiainpediatricpatientswithhypospadias |