Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial
Introduction Esketamine has unique advantages in combination with dexmedetomidine for sedation in young children, owing to its sympathetic activity and mild respiratory depression. However, the optimal dose is yet to be determined. In this study, we compared the different doses of intranasal esketam...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2453087 |
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| author | Dongjie Pei Ting Xiao Li Zeng Siwei Wei Lei Wang Zhen Du Shuangquan Qu |
| author_facet | Dongjie Pei Ting Xiao Li Zeng Siwei Wei Lei Wang Zhen Du Shuangquan Qu |
| author_sort | Dongjie Pei |
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| description | Introduction Esketamine has unique advantages in combination with dexmedetomidine for sedation in young children, owing to its sympathetic activity and mild respiratory depression. However, the optimal dose is yet to be determined. In this study, we compared the different doses of intranasal esketamine combined with dexmedetomidine for sedation during transthoracic echocardiography in toddlers.Patients and Methods A total of 121 eligible children aged 13 years, who were scheduled for transthoracic echocardiography were randomized into three groups. They were treated with intranasal dexmedetomidine 1 mcg.kg−1 + esketamine 0.5 mg.kg−1 (group S1), dexmedetomidine 1 mcg.kg−1 + esketamine 1 mg.kg−1 (group S2), or dexmedetomidine 1 mcg.kg−1 + esketamine 1.5 mg.kg−1 (group S3). The primary outcome was the success rate of sedation, other outcomes included HR, SpO2, onset time, wake-up time, and adverse effects.Results The success rate of sedation was significantly higher in groups S2 (85.4%) and S3 (87.5%) than ingroup S1 (60%) (p = 0.004). The baseline HR and SpO2 did not differ between the groups at the corresponding time points following drug administration. The onset time and duration of sedation in group S1 were significantly longer than those in groups S2 and S3 (p = 0.000). However, there were no differences in the wake-up time or adverse effects among the three groups.Conclusions Intranasal administration of 1 mg.kg−1 esketamine combined with 1 mcg.kg−1 dexmedetomidine provided satisfactory sedation in young children undergoing transthoracic echocardiography. This sedative approach offers a rapid onset of awakening with few side effects.Clinical trial registration number ChiCTR2200060976, 2022/06/14 (trail from August 2022 to January 2023) |
| format | Article |
| id | doaj-art-c989a098efcb4b8481a6f656f70faba7 |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj-art-c989a098efcb4b8481a6f656f70faba72025-01-17T17:08:02ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2453087Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trialDongjie Pei0Ting Xiao1Li Zeng2Siwei Wei3Lei Wang4Zhen Du5Shuangquan Qu6Department of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaDepartment of Anesthesiology, Hunan Children’s Hospital, Changsha, Hunan, ChinaIntroduction Esketamine has unique advantages in combination with dexmedetomidine for sedation in young children, owing to its sympathetic activity and mild respiratory depression. However, the optimal dose is yet to be determined. In this study, we compared the different doses of intranasal esketamine combined with dexmedetomidine for sedation during transthoracic echocardiography in toddlers.Patients and Methods A total of 121 eligible children aged 13 years, who were scheduled for transthoracic echocardiography were randomized into three groups. They were treated with intranasal dexmedetomidine 1 mcg.kg−1 + esketamine 0.5 mg.kg−1 (group S1), dexmedetomidine 1 mcg.kg−1 + esketamine 1 mg.kg−1 (group S2), or dexmedetomidine 1 mcg.kg−1 + esketamine 1.5 mg.kg−1 (group S3). The primary outcome was the success rate of sedation, other outcomes included HR, SpO2, onset time, wake-up time, and adverse effects.Results The success rate of sedation was significantly higher in groups S2 (85.4%) and S3 (87.5%) than ingroup S1 (60%) (p = 0.004). The baseline HR and SpO2 did not differ between the groups at the corresponding time points following drug administration. The onset time and duration of sedation in group S1 were significantly longer than those in groups S2 and S3 (p = 0.000). However, there were no differences in the wake-up time or adverse effects among the three groups.Conclusions Intranasal administration of 1 mg.kg−1 esketamine combined with 1 mcg.kg−1 dexmedetomidine provided satisfactory sedation in young children undergoing transthoracic echocardiography. This sedative approach offers a rapid onset of awakening with few side effects.Clinical trial registration number ChiCTR2200060976, 2022/06/14 (trail from August 2022 to January 2023)https://www.tandfonline.com/doi/10.1080/07853890.2025.2453087Esketaminesedationpediatricdexmedetomidinetransthoracic echocardiography |
| spellingShingle | Dongjie Pei Ting Xiao Li Zeng Siwei Wei Lei Wang Zhen Du Shuangquan Qu Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial Annals of Medicine Esketamine sedation pediatric dexmedetomidine transthoracic echocardiography |
| title | Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial |
| title_full | Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial |
| title_fullStr | Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial |
| title_full_unstemmed | Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial |
| title_short | Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial |
| title_sort | optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography a prospective double blind randomized trial |
| topic | Esketamine sedation pediatric dexmedetomidine transthoracic echocardiography |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2453087 |
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