Abstract: AIM: To investigate the preventive effect of ketamine with different doses on separation anxiety and emergence agitation (EA) after sevoflurane anesthesia in children for PC- NL (percutaneous nephrolithotomy lithotripsy) surgery.METHODS: Eighty children, ranging in age from 2-8 years old, undergoing PCNL surgery were randomly allocated to one of the 4 groups: group C received normal saline, group K0.5, K0.75 and K1 received ketamine 0.5 mg/kg, 0.75 mg/kg or 1.0 mg/kg intravenously before entering the operating room respectively. Children in four groups received conventional sevoflurane for maintain anesthesia. The separation anxiety score before induction was evaluated. Extubation time, post-anesthesia care unit stay time, postoperative nausea and vomiting, emergence agitation, and pain (the modified Children's Hospital of Eastern Ontario Pain Scale,Modified CHEOPS) were assessed.RESULTS: The preoperative separation anxiety scores in group K0.75 and group K1 were significantly lower than those in group K0.5 and group C(P<0.05). Time of extubation and post-anesthesia care unit stay in group K1 was significantly lower than that three groups(P<0.05). The incidence of EA and Modified CHEOPS were significantly higher than those three-ketamine groups(P<0.05),but there was no statistically significant differences among three ketamine groups(P>0.05).CONCLUSION: Ketamine 0.75 mg/kg administered before entering the operating room reduced separation anxiety, postoperative pain and incidence of EA without delay in recovery.

Key words: Emergence agitation, Children, Sevoflurane, Ketamine, Separation anxiety