Anesthesia methods and gastroscopic procedure
bradycardia
CHOKING
All children were fasted for at least 6 h, and peripheral intravenous access was established. A total of 50 ml of Pronase solution (400 U/ml ) was drunk 5 min before endoscopy to eliminate foam and improve endoscopic graphic clarity, which was a proteolytic enzymes that can dissolve mucus in stomach. Oxygen was inhaled continuously at 3 L/min through a nasal catheter throughout the process. Children’s heart rate (HR), noninvasive blood pressure (right upper arm), pulse oximetry (SPOEsketamine (50 mg/2 ml, Jiangsu Hengrui Pharmaceutical Co., Ltd., China) was diluted to 50 ml by another researcher unaware of the research content. The diluted drug concentration was 1 mg/ml, which was easy to calculate and use. The first child was administered with 0.1 mg/kg esketamine; 30 s after injection, 3 mg/kg propofol (200 mg/20 ml, Beijing Fresenius Kabi Co., Ltd., China ) was injected slowly by an experienced anesthesiologist. After the child was sedated successfully, the pediatrician attempted to insert the gastroscope. The study was carried out with a sequential method. If the induction of anesthesia failed (significant body movement or choking) in the first child, the dosage of esketamine would increase to 0.15 mg/kg (0.05 mg/kg interval difference) for the next patient. Otherwise, the dosage of esketamine would decrease to 0.05 mg/kg. The study was not terminated until nine crossover inflection points were reached. According to the Modified Observer’s Assessment of Alertness/Sedation scale (MOAA/S) [Once the child encountered bradycardia during the examination, 0.15 mg/kg atropine was immediately administered intravenously. If SPO