艾司氯胺酮在小儿围术期应用进展

艾司氯胺酮在患儿术前用药、术中麻醉、术后镇痛、门诊及日间手术中已应用广泛。术前用药可有效缓解患儿术前焦虑，促进患儿与父母的顺利分离，术前应用艾司氯胺酮不但有利于相对平稳的麻醉诱导过程，而且能够产生更少的精神不良反应及口腔分泌物。患儿术中持续输注低剂量艾司氯胺酮可有效降低阿片类药物剂量，且不影响苏醒质量，并减轻术后疼痛，同时可用于患儿术后镇痛。艾司氯胺酮单一或联合其他镇静镇痛药物可安全用于患儿内镜检查及治疗、诊断性检查及有创导管置入麻醉的应用，并有效减少其他镇静药物剂量，降低不良反应发生率。本文就艾司氯胺酮在患儿上述各方面应用进展进行综述，以期为临床应用提供参考。

Progress in the perioperative application of esketamine in children

Esketamine has been widely used in preoperative medication, intraoperative anesthesia, postoperative analgesia, outpatient and day surgery for pediatric patients. Preoperative medication can effectively alleviate preoperative anxiety in children and promote smooth separation from parents. Preoperative use of esketamine is not only beneficial for a relatively stable anesthesia induction process, but also can produce fewer adverse mental reactions and oral secretions. Continuous infusion of low-dose esketamine during surgery can effectively reduce the dosage of opioids in pediatric patients, without affecting the quality of recovery, and alleviate postoperative pain. It can also be used for postoperative analgesia in pediatric patients. Esketamine alone or in combination with other sedatives and analgesics can be safely used for endoscopic examination and treatment, diagnostic examination, and invasive catheterization anesthesia in pediatric patients, effectively reducing the dosage of other sedatives and reducing the incidence of adverse reactions. This article reviews the progress of the application of esketamine in various aspects of pediatric patients, in order to provide reference for clinical application.