Assessing pediatric anesthesia outcomes and prognostic factors: a comparative study of ketamine vs. ketamine + propofol.

Objective: To investigate the anesthesia outcomes of ketamine and propofol in pediatric anesthesia and analyze associated prognostic factors. Methods: A retrospective study was conducted on 160 children who underwent anesthesia and operation in Children's Hospital of Nanjing Medical University from 2020 to 2022. The anesthesia outcomes was analyzed by comparing the blood oxygen saturation (SpO2 ), heart rate (HR), mean arterial pressure (MAP) at before (T1 ), during (T2 ) and after (T3 ) operations, recovery time after anesthesia, post-anesthesia care unit (PACU) stay, adverse reactions, as well as the Steward and FLACC scores between the control and research groups. Univariate analysis and logistic regression analysis were used to identify the prognostic factors in pediatric anesthesia. Results: The changes in SpO2 , HR, and MAP were different between the two groups at different time points ( P < 0.05). There were significant differences in anesthesia recovery time, PACU stay, Steward and FLACC scores, and incidence of adverse reactions between the two groups ( P < 0.05). Logistic regression analysis revealed that operation time ≥ 49.5 minutes ( P = 0.001, OR = 3.828, 95% CI: 1.715-8.544) and single use of ketamine for anesthesia ( P = 0.048, OR = 2.257, 95% CI: 1.006-5.063) were independent risk factors for postoperative delirium. Conclusion: Combining propofol with ketamine for pediatric anesthesia yields superior clinical outcome compared to using ketamine alone. This combined approach can effectively maintain stable circulation during operation, lead to shorter anesthesia recovery time, ensure high recovery quality, reduce postoperative pain, adverse reaction rate, and risk of post-anesthesia delirium in children, thereby improving the prognosis.