Efficacy of low dose esketamine infusion during surgery for post-operative pain management in Pediatrics Patients
The primary objective is to assess its impact on post-operative pain intensity and opioid requirements. Secondary outcomes include monitoring for adverse events, sedation levels, and overall patient recovery. By contributing to the growing body of pediatric anesthesia literature, this study seeks to inform clinical guidelines and optimize perioperative analgesic strategies in children. This cross-sectional analytical study assessed the efficacy of intraoperative low-dose esketamine infusion for post-operative pain in pediatric surgical patients. Conducted in Pakistan and Bangladesh, it included 104 children aged 3–12 undergoing elective surgery. Group A received esketamine (0.25 mg/kg/h); Group B received standard care. Pain scores (FLACC), opioid use, and adverse effects were recorded over 6 hours post-op. Esketamine significantly reduced pain and opioid need without serious side effects. Both groups were demographically and clinically comparable, ensuring internal validity. Group A (esketamine) showed significantly lower post-operative pain scores at all-time points (p < 0.001). Esketamine reduced opioid consumption (0.06 vs. 0.14 mg/kg) and delayed first rescue analgesia (4.8 vs. 2.9 hrs). Mild sedation was noted in the esketamine group, with no serious adverse effects; hallucinations were rare and manageable. These findings support esketamine's efficacy as an opioid-sparing adjunct in pediatric post-operative pain management. Intraoperative low-dose esketamine effectively reduces post-operative pain and opioid use in pediatric surgery with a manageable safety profile. Its use in multimodal analgesia may enhance recovery, though further research is needed for long-term validation.
