Advances in clinical and experimental medicine : official organ Wroclaw Medical University · 2026
Dose-dependent effect of esketamine on preventing rocuronium-induced limb withdrawal in preschool children.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Jie, Zhou Zhiguo, Ma Wen-Lu
Аннотация
BACKGROUND: Rocuronium injection often causes limb withdrawal reactions in preschool children during anesthesia induction, which can lead to adverse effects. Esketamine has been reported to reduce such reactions, but the optimal dose remains unclear.
OBJECTIVES: To observe the effect of different doses of esketamine administered in advance on limb withdrawal reactions caused by rocuronium in preschool children.
MATERIAL AND METHODS: From January to December 2024, children aged 2-6 years (American Society of Anesthesiologists Physical Status Classification System (ASA) I-II) undergoing elective surgery with general anesthesia induction using rocuronium at Hangzhou Children's Hospital were enrolled, regardless of gender (90 cases in total). Patients were divided using a random number table into 3 groups: a control group (group C), an esketamine 0.1 mg/kg group (group K1), and an esketamine 0.2 mg/kg group (group K2). Each group received either saline (group C), 0.1 mg/kg esketamine (group K1), or 0.2 mg/kg esketamine (group K2), with 30 cases in each group. Thirty seconds later, all patients were administered rocuronium intravenously. Mean arterial pressure (MAP) and heart rate (HR) were recorded at 4 time points: before anesthesia induction (T0), before test drug injection (T1), before rocuronium injection (T2), and after rocuronium injection (T3). The incidence and severity of limb withdrawal reactions after rocuronium injection and adverse reactions were recorded.
RESULTS: Compared with T0, MAP and HR significantly decreased in all 3 groups before test drug injection (T1) (p < 0.05). After rocuronium injection (T3), MAP and HR significantly increased in group C (p < 0.05). Heart rate significantly increased at T2 and T3 in group K2 (p < 0.05). The incidence of limb withdrawal reactions was 43.33% in group C, 16.67% in group K1, and 13.33% in group K2, with statistically significant differences among the groups. The severity of limb withdrawal reactions also differed significantly among the 3 groups.
CONCLUSIONS: Prophylactic intravenous injection of 0.1 mg/kg esketamine effectively reduces the limb withdrawal reaction caused by rocuronium injection.
OBJECTIVES: To observe the effect of different doses of esketamine administered in advance on limb withdrawal reactions caused by rocuronium in preschool children.
MATERIAL AND METHODS: From January to December 2024, children aged 2-6 years (American Society of Anesthesiologists Physical Status Classification System (ASA) I-II) undergoing elective surgery with general anesthesia induction using rocuronium at Hangzhou Children's Hospital were enrolled, regardless of gender (90 cases in total). Patients were divided using a random number table into 3 groups: a control group (group C), an esketamine 0.1 mg/kg group (group K1), and an esketamine 0.2 mg/kg group (group K2). Each group received either saline (group C), 0.1 mg/kg esketamine (group K1), or 0.2 mg/kg esketamine (group K2), with 30 cases in each group. Thirty seconds later, all patients were administered rocuronium intravenously. Mean arterial pressure (MAP) and heart rate (HR) were recorded at 4 time points: before anesthesia induction (T0), before test drug injection (T1), before rocuronium injection (T2), and after rocuronium injection (T3). The incidence and severity of limb withdrawal reactions after rocuronium injection and adverse reactions were recorded.
RESULTS: Compared with T0, MAP and HR significantly decreased in all 3 groups before test drug injection (T1) (p < 0.05). After rocuronium injection (T3), MAP and HR significantly increased in group C (p < 0.05). Heart rate significantly increased at T2 and T3 in group K2 (p < 0.05). The incidence of limb withdrawal reactions was 43.33% in group C, 16.67% in group K1, and 13.33% in group K2, with statistically significant differences among the groups. The severity of limb withdrawal reactions also differed significantly among the 3 groups.
CONCLUSIONS: Prophylactic intravenous injection of 0.1 mg/kg esketamine effectively reduces the limb withdrawal reaction caused by rocuronium injection.