The Impact of Intranasal Esketamine on Emergence Agitation in Children Undergoing Adenotonsillectomy: A Randomized Controlled Study
Why this work is in the frame
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Bibliographic record
Abstract
Purpose: To investigate the efficacy of intranasal esketamine in reducing the incidence of emergence agitation (EA) in pediatric patients undergoing adenotonsillectomy and to determine the optimal dose of esketamine. Methods: A total of 204 children aged 3-6 years scheduled for adenotonsillectomy were randomly assigned to three groups. All participants received a standardized anesthetic induction protocol. Following tracheal intubation, they were administered intranasally 0.5 mg/kg esketamine (group LE), 1 mg/kg esketamine (group HE), or an equivalent volume of saline (group C). Anesthesia was maintained with sevoflurane during surgery, and the children were transferred to the post-anesthesia care unit (PACU) after extubation. The highest scores on the Pediatric Anesthesia Emergence Delirium (PAED) scale and the modified Children's Hospital of Eastern Ontario Pain Scale (m-CHEOPS) in the PACU were recorded. The incidence of EA, defined as PAED ≥ 10, was calculated for each group. Additionally, changes in vital signs after intranasal administration, surgery time, anesthesia time, extubation time, eye-opening time, recovery time, and the incidence of adverse reactions were compared among the three groups. Results: = 0.025). Conclusion: Intranasal esketamine at a dose of 0.5 mg/kg significantly reduces the incidence of EA following pediatric adenotonsillectomy. Increasing the dose to 1 mg/kg does not confer additional benefit in preventing EA and may instead delay extubation.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it