Abstract: Objective To explore the effect of continuous low-dose infusion of esmolamine on intraoperative dosage of opioids and awakening quality in general anesthesia in pediatric surgeries. Methods A total of 100 children (6-8 years of age) undergoing pediatric surgery under general anesthesia were randomized equally into observation group and control group. In the observation group, the children received an intravenous injection of 0.1mg/kg esmolamine 10 min before induction of general anesthesia, followed by intravenous infusion of esmolamine at 2 μg · kg-1 · min-1 until the end of the operation; those in the control group were infused with the same volume of normal saline instead of esmolamine in the same manner. The dosage of remifentanil during operation, recovery time of spontaneous breathing, recovery time of consciousness and extubation time were recorded in all the cases. The VAS score at 15, 30 and 60 min after extubation were assessed, and intravenous injection of naborphine 0.3 mg/kg was given for a VAS score ≥4; the total dosage of naborphine and adverse events were recorded for all the patients. Results The total dose of remifentanil was significantly lower in the observation group than in the control group, but the spontaneous respiratory recovery time, consciousness recovery time and extubation time did not differ significantly between the two groups. The VAS scores at 15, 30 and 60 min after extubation were all better in the observation group than in the control group; the total intraoperative dose of naborphine was significantly lower in the observation group. Conclusion Continuous infusion of low-dose esmolamine during pediatric surgery can effectively lower intraoperative dosage of opioids and reduce pain during recovery without affecting the quality of awakening.

Key words: esketamine; remifentanil; opioid-reduced anesthesia; low dose