To investigate the application effect of esmketamine in venipuncture of children undergoing burn surgery.

A total of 168 children who underwent burn scar surgery in the First Affiliated Hospital of Air Force Military Medical University from January 2020 to August 2021 were randomly divided into 52 cases in the routine group, 56 cases in the sevoflurane group and 60 cases in the esmketamine group. The children in the routine group underwent routine venipuncture, the children in the sevoflurane group inhaled sevoflurane before venipuncture, and the children in the esmketamine group entered the room for venipuncture after intramuscular injection of esmketamine outside the operating room. The heart rate, respiration, blood oxygen saturation, the success rate of one-time puncture, the number of puncture, catheter type (22G or 24G), the time of successful catheterization, the time from entering to successful puncture and the occurrence of complications were compared among the three groups.

At admission, the heart rate [(130.98±5.73) times/min, (131.27±5.42) times/min], respiration [(31.88±3.63) times/min, (32.11±3.50) times/min] in the routine group and sevoflurane group were higher than those in the esketamine group [(102.86±9.32) times/min, (21.75±3.48) times/min], and the blood oxygen saturation (91.62%±2.64%, 92.45%±2.61%) were lower than that in the esketamine group (98.83%±2.09%). At the time of puncture, the heart rate [(104.12±11.26) times/min, (100.28±6.80) times/min], respiration [(21.98±4.43) times/min, (20.62±1.75) times/min]in the sevoflurane group and the esketamine group were lower than those in the routine group [(140.83±5.94) times/min, (37.40±3.13) times/min], and the blood oxygen saturation (98.41%±3.22%, 99.32%±0.98%) were higher than that in the routine group (88.04%±1.58%), with statistically significant differences (P<0.05). The success rate of one-time puncture was higher in the esketamine group (63.3%) than that in the routine group (32.7%) and the sevoflurane group (51.8%), and the number of puncture in the routine group (2.94±1.81) was more than that in the sevoflurane group (2.04±1.25) and the esketamine group (1.65±0.80), with statistically significant differences (P<0.05). The proportion of catheter type 22G in the routine group (15.4%) was lower than that of the sevoflurane group (32.1%) and the esketamine group (43.3%), with statistically significant difference (P<0.05). The time from entering the room to successful puncture in the routine group [(9.41±2.17)min] was longer than that in the sevoflurane group [(6.58±1.60)min] and the esketamine group [(4.18±1.63)min], and the difference between the three groups was statistically significant (P<0.05). The incidence of complications at the puncture site in the routine group were higher than those in the sevoflurane group and the esketamine group, with statistically significant difference (P<0.05).

Venipuncture after intramuscular injection of esmketamine before surgical anesthesia can stabilize the vital signs of children when entering the room, improve the success rate of primary puncture, shorten the time from entering the room to successful puncture, and reduce the non-surgical time, which has a good clinical effect.