Comparison of Esketamine and Sevoflurane on Emergence Agitation
Status:
Recruiting
Trial end date:
2022-05-17
Target enrollment:
Participant gender:
Summary
Emergence agitation is the most common reason for post-anesthesia care unit delay.
Sevoflurane is used frequently inhalational anaesthetic agent to provide pediatric
anaesthesia because of the nonirritant nature. It has been successfully used for keeping
spontaneous breathing without tracheal intubation. However, sevoflurane may cause emergence
agitation as the incidence varied from 10%-80%. Although there are many sedative agents to
reduce its incidence, such as propofol, midazolam, a2 adrenergic receptor agonists and
ketamine, the efficacy remains limited.
Ketamine, a neuroleptic anesthetic agent, contains two optical isomers, s(+)-ketamine
(esketamine) and R(-)-ketamine. Esketamine is a right-handed split of ketamine, which has
enhanced analgesic potency and lower incidence of psychotropic side effects compared to
ketamine. It stimulate breathing due to N-Methyl-D-Aspartate receptor blockade, and could
even effectively countered remifentanil-induced respiratory depression. The investigators
compared the effectiveness of esketamine and sevoflurane in reducing the incidence of
emergence agitation after painless ophthalmological procedure in pediatric patients.