Paediatric anaesthesia & critical care
Effects of Esketamine on Emergence Delirium in Children Undergoing Sevoflurane Anesthesia: A Systematic Review, Meta‐Analysis, and Trial Sequential Analysis
Pooled resultResult — go to the resultRelative risk 0.35 95% CI 0.26–0.48Authors' conclusion
Esketamine demonstrates promising efficacy for preventing emergence delirium and improving postoperative pain in children.
Study context
- Population
- Children undergoing surgical procedures under sevoflurane-based GA
- Participants
- 916 children · 8 RCTs
- Comparison
- Esketamine vs placebo
- Outcome
- Incidence of emergence delirium
Methodological detailsrandom-effects models, meta-regression, trial sequential analysis, GRADE, Certainty of evidence moderate, except extubation time (low), No study at high risk of bias; 4 studies raised some concerns
- Random-effects models
- Meta-regression
- Trial sequential analysis
- GRADE
- Certainty of evidence moderate, except extubation time (low)
- No study at high risk of bias; 4 studies raised some concerns
Pooled result
As reported in the abstract
Relative risk
0.35
95% CI 0.26–0.48
P < 0.0001
Esketamine vs Placebo
RR 0.35 (95% CI 0.26–0.48); P < 0.0001
Further pooled results
| Outcome | SMD (95% CI) | P value | |
|---|---|---|---|
| Postoperative pain scores | −0.58 (−0.79 to −0.37) | P < 0.0001 | |
| −1−0.500.5Difference (linear scale) |
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| PONV | 0.69 (0.49–0.97) | P = 0.0304 | |
| 0.512Relative risk (log scale) |
Extubation time
- Extubation time modestly prolonged, MD (min)
- 1.72 min; 95% CI 0.20-3.24; p = 0.0267
- Low certainty of evidence
PACU stay
- No statistically significant difference
Emergence delirium by dosing regimen, surgical type, route and timing (subgroup)
- No significant differences between dosing regimens, surgical types, routes or timing of administration
Meta-regression of emergence delirium RR on anesthesia duration
- Significant association with anesthesia duration (β)
- 0.98, p = 0.042
- No other significant associations for the other covariates
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| PONV | 0.69 (0.49–0.97) | P = 0.0304 | |
| 0.512Relative risk (log scale) |
Original publication
Effects of Esketamine on Emergence Delirium in Children Undergoing Sevoflurane Anesthesia: A Systematic Review, Meta‐Analysis, and Trial Sequential Analysis. Paediatr Anaesth. Published 6 August 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →