The Impact of Intranasal Esketamine on Emergence Agitation in Children Undergoing Adenotonsillectomy: A Randomized Controlled Study

Drug Design Development and Therapy  – November 01, 2025

Source: OpenAlex

Summary

Intranasal esketamine at 0.5 mg/kg effectively reduces the incidence of emergence agitation (EA) in children following adenotonsillectomy, with a sample size of 100 participants showing a notable decrease in EA rates. In contrast, increasing the dosage to 1 mg/kg does not enhance this protective effect and may even prolong extubation times. This highlights the potential of intranasal administration of ketamine as a promising anesthetic strategy, particularly for pediatric patients with obstructive sleep apnea undergoing surgery.

Abstract

Intranasal esketamine at a dose of 0.5 mg/kg significantly reduces the incidence of EA following pediatric adenotonsillectomy. Increasing the dose to 1 mg/kg does not confer additional benefit in preventing EA and may instead delay extubation.

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