The Impact of Intranasal Esketamine on Emergence Agitation in Children Undergoing Adenotonsillectomy: A Randomized Controlled Study.
Drug design, development and therapy January 1, 2025 Jiajia Li, Gaili Jia, Ruixian Wang et al.
Intranasal esketamine at 0.5 mg/kg significantly reduces emergence agitation after pediatric adenotonsillectomy. In a trial of 204 children aged 3–6 years, the incidence of emergence agitation (PAED ≥ 10) was 10.45% in the low-dose esketamine group versus 29.85% in the saline group. The higher 1 mg/kg dose did not further reduce agitation (12.12%) and prolonged extubation time. Children receiving 0.5 mg/kg also had lower pain scores and required less rescue propofol and fentanyl. The findings suggest 0.5 mg/kg intranasal esketamine is effective for preventing emergence agitation, while 1 mg/kg adds no benefit and may delay recovery.