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SYSTEMATIC REVIEW article

Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1505408
This article is part of the Research Topic Post-Operative Neuropsychiatric Disorders, volume II View all articles

Effect of perioperative esketamine use on emergency delirium in children undergoing tonsillectomy and adenoidectomy: a systematic review and meta-analysis of randomized controlled trials

Provisionally accepted
Junfeng Liu Junfeng Liu 1Jinming Liu Jinming Liu 1Hong Sun Hong Sun 1Xue Chen Xue Chen 1Chunhui Wang Chunhui Wang 1Daoyun Lei Daoyun Lei 2Chao Han Chao Han 1*
  • 1 Department of Anesthesiology, Yixing People's Hospital, Yixing, China
  • 2 Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Emergence delirium is a common perioperative complication in children after general anesthesia which may cause harm to healthcare workers and family members caring for the child, increase the incidence of postoperative complications, and be detrimental to the child's postoperative recovery. It is particularly important to prevent the occurrence of emergence delirium. However, there are no high-quality studies confirming the effect of esketamine on emergence delirium. In this study, a meta-analysis was used to explore the effect of perioperative esketamine on the incidence of emergence delirium. We searched Embase, The Cochrane Library, PubMed, MEDLINE, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, VIP, and SinoMed from inception to 1 September, 2024. Two evaluators identified randomized controlled trials comparing perioperative use of esketamine with placebo or other drugs in children undergoing tonsillectomy and adenoidectomy. Data synthesis was performed by using Review Manager 5.4 software. Our results showed that perioperative use of esketamine could significantly reduce the incidence of ED in children undergoing tonsillectomy and adenoidectomy. However, the optimal dose and timing of esketamine administration for preventing ED remains to be explored.

    Keywords: emergence delirium, Esketamine, Meta-analysis, Perioperative Medicine, Systematic review

    Received: 02 Oct 2024; Accepted: 14 Jan 2025.

    Copyright: © 2025 Liu, Liu, Sun, Chen, Wang, Lei and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chao Han, Department of Anesthesiology, Yixing People's Hospital, Yixing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.