艾司氯胺酮滴鼻在患儿术前镇静中的应用进展

Application of esketamine nasal drop in preoperative sedation of children

艾司氯胺酮作为一种全身麻醉药物,具有镇静、镇痛以及临床剂量范围内呼吸抑制轻微等优势,适合用于患儿术前镇静。临床上多采用静脉注射方式给药,但滴鼻给药不受静脉通路影响,起效迅速且无首过效应。推荐的滴鼻给药剂量为1 mg/kg,其镇静效果可靠,不良反应较少。当艾司氯胺酮与右美托咪定或咪达唑仑复合使用时,可明显缩短镇静起效时间,减少各自药物用量,减轻患儿术后疼痛。单独或复合右美托咪定滴鼻均可安全用于合并肺动脉高压的先天性心脏病患儿,有助于维持血流动力学稳定。本文就艾司氯胺酮滴鼻的临床应用现状进行总结,为其合理应用提供参考。

As a general anesthetic,esketamine has the advantages of sedation,analgesia,and slight respiratory depression within the clinical dose range,which is suitable for preoperative sedation in children.Intravenous injection is mostly used in clinical practice,but nasal dropping is not affected by the venous access and has a rapid onset time with no first pass effect.The recommended nasal dose of esket-amine is 1 mg/kg,with reliable sedation effect and few adverse reactions.When combined with dexmedeto-midine or midazolam,sedation onset time of esketamine can be significantly shortened,the respective drug dosage can be reduced,and postoperative pain can be alleviated.Nasal dropping alone or combined with dexmedetomidine can be safely used in children with congenital heart disease complicated by pulmonary hy-pertension,which helps to maintain the stability of hemodynamic.This article summarizes the current situa-tion of clinical application of nasal dropping of esketamine to provide reference for its rational application.