Trial reportDrug design, development and therapy2025
Intranasal Esketamine Premedication Reduces Sevoflurane Requirements During Laryngeal Mask Airway Insertion in Pediatric Patients: A Randomized Controlled Trial.
Trial report in Drug design, development and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: This study evaluated whether intranasal esketamine premedication reduces sevoflurane requirements for laryngeal mask airway (LMA) insertion in young children. Patients and Methods: This randomized, double-blind, placebo-controlled trial enrolled 90 children (2-5 years) undergoing elective strabismus surgery. Participants received intranasal premedication with either saline (control), esketamine 0.5 mg/kg, or esketamine 1.0 mg/kg. The primary outcome was the minimum alveolar concentration of sevoflurane needed for successful LMA placement, determined using Dixon's up-and-down method. Secondary outcomes included anesthesia induction quality (4-point cooperation scale), emergence delirium (Pediatric Anesthesia Emergence Delirium scale), emergence time (from sevoflurane discontinuation to purposeful response), behavioral changes at day 3 (Post-Hospitalization Behavior Questionnaire), and adverse events. Results: Intranasal esketamine produced dose-dependent reductions in sevoflurane requirements: 2.16 ± 0.18% (control), 1.87 ± 0.17% (0.5 mg/kg), and 1.50 ± 0.19% (1.0 mg/kg), representing decreases of 13.4% and 30.6%, respectively. The higher esketamine dose significantly improved induction quality (p=0.002), reduced emergence delirium (13.8% versus 46.4%, p=0.007), and decreased negative postoperative behavioral changes on day 3 (20.7% versus 53.6%, p=0.010). Emergence time and adverse event rates remained similar across groups. Conclusion: Intranasal esketamine premedication effectively reduces sevoflurane requirements for LMA placement in children in a dose-dependent manner. The 1.0 mg/kg dose provides optimal clinical benefits without prolonging recovery or increasing complications. This approach offers pediatric anesthesiologists a practical method to reduce volatile anesthetic exposure while improving patient outcomes and potentially minimizing anesthetic-related risks.
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