Journal of Shanghai Jiao Tong University (Medical Science) >

2022 , Vol. 42 >Issue 12: 1706 - 1711

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.12.008

Clinical research

Effect of lidocaine on median effective dose of esketamine for children undergoing circumcision

  • Bo LI ,
  • Ming ZHU ,
  • Jijian ZHENG
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  • Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
ZHU Ming, E-mail: zhu-ming@scmc.com.cn.

Received date: 2022-05-31

  Accepted date: 2022-11-28

  Online published: 2022-12-28

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Abstract

Objective ·To evaluate the median effective dose (ED50) and cardiovascular stability of esketamine in combination with lidocaine for pediatric patients undergoing circumcision. Methods ·Children aged 3?7 years selected for circumcision between April and June 2021 in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicinewere enrolled in this study. All children enrolled were administrated 0.5% lidocaine 1.5 mg/kg intravenously after anesthesia was induced by esketamine. The ED50 of esketamine required for children undergoing circumcision was determined by Dixon's up-and-down method, which calculated the mean of the crossover midpoints. Additionally, ED50 and ED95 of esketamine were estimated by probit regression. Onset time, wake-up time, vital signs including heart rate, pulse oxygen saturation and mean artery pressure, and adverse events were recorded. Differences in age, weight of the patients between the two groups were compared by one-way ANOVA. Differences in onset time, wake-up time, and vital signs including heart rate, pulse oxygen saturation (SpO2) and mean arterial pressure in each time point between the two groups were compared by using the independent samples t-test. The ED50 values of esketamine was compared between the two groups by Mann-Whitney U test. Results ·When administrated in combination with lidocaine, the ED50 of esketamine for children undergoing circumcision was 1.55 mg/kg (95% CI 1.47?1.63). Compared to the data of our previous study, the ED50 of esketamine required for children undergoing circumcision in combination with lidocaine was significantly lower than that of esketamine solo agent [ED50 =1.90 mg/kg (95% CI 1.75?2.05)] (P=0.001). The mean arterial pressure of children pretreated with lidocaine was significantly lower than that of esketamine solo agent at each time point during the surgery (P=0.000, P=0.004, P=0.010), and no significant effect on heart rate was observed. A transient decrease in SpO2 was observed when esketamine was used in combination with lidocaine. Conclusion ·Anesthesia induced by esketamine combined with lidocaine can significantly reduce the ED50 of esketamine required for pediatric patients undergoing circumcision, and better stability of blood pressure is achieved. However, transient respiratory depression should be noted.

Key words： esketamine; lidocaine; children; circumcision; median effective dose

Cite this article

Bo LI , Ming ZHU , Jijian ZHENG . Effect of lidocaine on median effective dose of esketamine for children undergoing circumcision[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022 , 42(12) : 1706 -1711 . DOI: 10.3969/j.issn.1674-8115.2022.12.008

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