Results
Anxiety, Tetralogy of Fallot, ductus arteriosus, coronary right ventricular fistula, ventricular septal defect, TOF, PVS, CHD, aortic stenosis, atrial septal defect
REGRESSION, PULMONARY VALVE STENOSIS, OBSTRUCTIVE SLEEP APNEA SYNDROME, AORTIC STENOSIS, SEPARATION, SEPARATION
Thirty-four patients were included in the study,, ASAI–III,21 boys and 13 girls, with a mean age of 22.5 ± 16.4 (4–54) months and a mean weight of 11.2 ± 3.6 (5.5–20.5) kg. The mean weight for successful and failed sedation was 11.0 ± 4.0 kg and 11.5 ± 3.1 kg, respectively. The CHD of the patients included ventricular septal defect in 17, atrial septal defect in 9, pulmonary valve stenosis (PVS) in 2, Tetralogy of Fallot (TOF) in 2, and aortic stenosis in 1, patent ductus arteriosus in 1, and coronary right ventricular fistula in 1. The flow chart of the research process is indicated in Fig. 
Participant flow chartNotes: Twenty-one patients were excluded from the study based on the exclusion criteria, 16 were excluded due to the inability to separate from parents/guardians, and 5 due to obstructive sleep apnea syndrome.Nineteen (55.9%) of the 34 patients who achieved successful sedation with intranasal esketamine were first included for analysis, in whom the effect onset time (min) was 20.5 ± 5.3 min, the quickest sedation onset time was 11.5 min, and the slowest was 28 min with a mean of 20.5 min. The other 15 patients who failed to achieve sedation were also included for analysis, including 9 cases of parental separation failure (4 children were unsuccessful in separating from their parents/guardians and sedation failure)and 6 cases of loss of sedation. After including the drug dose covariate and the dependent variable of response success, the optimal solution was obtained after 12 iterations. Using the probability regression method, the ED
The Actual response curves and drug doses for intranasal esketamineNotes: The Esketamine dose for each patient. A successful dose is denoted by a solid circle; a failed dose is denoted by an open circle. The horizontal arrows represent crossover midpoints (failure to success).Heart rate, SpO
Vital signs of the pediatric patientsHR, heart rate; MAP, mean arterial pressure; SpONote: The observational parameters were observed continuously. Analysis of the mean vital signs obtained at the designated time points indicated that the hemodynamics and other vital signs remained generally stable throughout the experimental period and showed no significant difference between successful and failed sedation.
Ramsay Sedation Scale scores at all designated time pointsNote: The Ramsay Sedation Scale scores in successful sedation cases were significantly higher than the mean values of the sedation scores in all included patients at all designated time points. The final Parental Separation Anxiety Scale at 30 min was 1.3 ± 0.5 in successful sedation cases, significantly lower than 1.8 ± 1.0 in the whole cohort. All the above results showed statistically significant differences. *, P < 0.05