{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:24:15Z","timestamp":1787955855998,"version":"build-2784847793"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T00:00:00Z","timestamp":1671494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"\n Background:<\/jats:bold>\n Emergency agitation is a common postoperative complication in pediatric patients after general anesthesia. The aim of this study was to explore the effects of a low dose of esketamine on emergency agitation in children following tonsillectomy.\n <\/jats:p>\n \n Materials and Methods:<\/jats:bold>\n Eighty children were recruited prospectively to this study and divided into the esketamine group and the control group (40 cases in each group). The induction and maintenance of anesthesia were the same in both groups. At the end of surgery, the esketamine group received 0.25\u00a0\u03bcg\/kg esketamine, while the control group received the same volume of normal saline. The extubation time, time to eye opening, Ramsay sedation scale and time to discharge from the post-anesthesia care unit (PACU) were recorded during post-anesthesia care unit. Postoperative complications, such as emergency agitation, respiratory depression, hypertension, tachycardia, nightmares, nausea, and vomiting, were also recorded.\n <\/jats:p>\n \n Results:<\/jats:bold>\n The incidence of emergency agitation was lower in the esketamine group compared with that in the control group (5%\n vs<\/jats:italic>\n . 27.5%,\n p<\/jats:italic>\n = 0.006). The time to eye opening was longer in the esketamine group than in the control group (17.2 \u00b1 2.7\n vs<\/jats:italic>\n . 15.5 \u00b1 2.3\u00a0min,\n p<\/jats:italic>\n = 0.005). However, the extubation time and time to discharge from PACU were similar between the two groups.\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n Low-dose of esketamine decreases the incidence of emergency agitation in children after tonsillectomy without delaying extubation time and increasing the postoperative side effects. (\n www.chictr.org.cn<\/jats:ext-link>\n , registration number: ChiCTR2100054178).\n <\/jats:p>","DOI":"10.3389\/fphar.2022.991581","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T23:59:20Z","timestamp":1671494360000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["Low-dose esketamine for the prevention of emergency agitation in children after tonsillectomy: A randomized controlled study"],"prefix":"10.3389","volume":"13","author":[{"given":"Qi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaming","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e5566","DOI":"10.1097\/MD.0000000000005566","article-title":"Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation\/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy: A CONSORT-prospective, randomized, controlled clinical trial","volume":"95","author":"Cao","year":"2016","journal-title":"Med. Baltim."},{"key":"B2","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1111\/j.1460-9592.2010.03375.x","article-title":"Emergence agitation after cataract surgery in children: A comparison of midazolam, propofol and ketamine","volume":"20","author":"Chen","year":"2010","journal-title":"Paediatr. Anaesth."},{"key":"B3","doi-asserted-by":"publisher","first-page":"72","DOI":"10.21315\/mjms2021.28.5.7","article-title":"Comparison of the effect of ketamine, ketamine-midazolam and ketamine-propofol on post-tonsillectomy agitation in children","volume":"28","author":"Fattahi-Saravi","year":"2021","journal-title":"Malays J. Med. 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Anesthesiol."},{"key":"B10","first-page":"184","article-title":"Postanesthetic emergence agitation in pediatric patients under general anesthesia","volume":"24","author":"Mohkamkar","year":"2014","journal-title":"Iran. J. Pediatr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e0128450","DOI":"10.1371\/journal.pone.0128450","article-title":"Effect of dexmedetomidine on preventing postoperative agitation in children: A meta-analysis","volume":"10","author":"Ni","year":"2015","journal-title":"PLoS One"},{"key":"B12","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1002\/da.22875","article-title":"Efficacy of intravenous ketamine treatment in anxious versus nonanxious unipolar treatment-resistant depression","volume":"36","author":"Salloum","year":"2019","journal-title":"Depress. Anxiety"},{"key":"B13","doi-asserted-by":"publisher","first-page":"4135","DOI":"10.2147\/DDDT.S224553","article-title":"Pharmacokinetics and safety of esketamine in Chinese patients undergoing painless gastroscopy in comparison with ketamine: A randomized, open-label clinical study","volume":"13","author":"Wang","year":"2019","journal-title":"Drug Des. Devel Ther."},{"key":"B14","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1111\/aas.13774","article-title":"Risk factors for emergence agitation in adults after general anesthesia: A systematic review and meta-analysis","volume":"65","author":"Wei","year":"2021","journal-title":"Acta Anaesthesiol. Scand."},{"key":"B15","doi-asserted-by":"publisher","first-page":"580226","DOI":"10.3389\/fped.2020.580226","article-title":"Effects of dexmedetomidine on emergence agitation and recovery quality among children undergoing surgery under general anesthesia: A meta-analysis of randomized controlled trials","volume":"8","author":"Yang","year":"2020","journal-title":"Front. Pediatr."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2821","DOI":"10.2147\/JPR.S177122","article-title":"Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: A randomized trial","volume":"11","author":"Zhong","year":"2018","journal-title":"J. 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