Scholarlink

Purpose <p>To investigate the effect of intraoperative low-dose esketamine administered at anesthesia induction on postoperative quality of recovery in total laparoscopic hysterectomy.</p> Patients and methods <p>One-hundred six female patients scheduled for elective total laparoscopic hysterectomy were randomly divided into saline group (group P) and esketamine group (group S). Group P received induction with normal saline, propofol, sufentanil, midazolam, and rocuronium, while group S received induction with low-dose esketamine (0.25&#xa0;mg/kg), propofol, sufentanil, midazolam, and rocuronium. Both groups were maintained with intravenous infusions of propofol and remifentanil. The quality of recovery (QoR-40), Numerical Rating Scale (NRS), and Pittsburgh Sleep Index (PSQI) scores were assessed at 8, 24, 48, and 72&#xa0;h, 7&#xa0;days, and 30-day post-surgery. Hamilton Depression Scale (HAMD) scores were evaluated at 72&#xa0;h, 7&#xa0;days, and 30-day post-surgery. Intraoperative hemodynamics, remifentanil consumption, inflammatory reactions, and adverse reactions were also documented.</p> Results <p>Both groups had similar QoR-40 scores at each time point (<i>P</i> &gt; 0.05). Patients in group S had less intraoperative remifentanil use (<i>P</i> &lt; 0.001), less consumption of phenylephrine (<i>P</i> = 0.005), fewer episodes of hypotension (<i>P</i> &lt; 0.001), and shorter extubation time and stay in postanesthesia care unit (PACU) (<i>P</i> &lt; 0.001). The NRS scores after extubation (<i>P</i> = 0.007), 8 h (<i>P</i> = 0.027) and 48 h (<i>P</i> = 0.016) after surgery, and the postoperative NLR (<i>P</i> = 0.003) and postoperative 24-h PSQI score (<i>P</i> = 0.024) were significantly lower in group S. The mean blood pressure (MBP) was higher at 10 min after incubation (T3) (<i>P</i> &lt; 0.001). The heart rate (HR) was faster at 3 min (T1) (<i>P</i> = 0.005), 10 min (T3) (<i>P</i> = 0.023), and 30 min (T4) (<i>P</i> = 0.014) after incubation and complete end of surgery (T5) (<i>P</i> = 0.010) in group S. Multiple linear regression analyses demonstrated that higher education was associated with better recovery (<i>P</i> &lt; 0.05).</p> Conclusion <p>In patients undergoing total laparoscopic hysterectomy, one injection of low-dose esketamine at anesthesia induction did not affect QoR-40 scores. However, esketamine stabilized intraoperative hemodynamics, decreased intraoperative opioid requirements, and shortened postoperative extubation time and PACU stay. It also alleviated postoperative inflammatory response and pain without causing adverse effects.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effect of low-dose esketamine on postoperative quality of recovery in total laparoscopic hysterectomy: a randomized controlled trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月23日

查看全文
  • Jing Zhang,
  • Zheng Niu,
  • Ting Wang,
  • Lianya Yu,
  • Xinyi Ren,
  • Shurui Zhang,
  • Yuwei Zhu,
  • Dunyi Qi

摘要

Purpose

To investigate the effect of intraoperative low-dose esketamine administered at anesthesia induction on postoperative quality of recovery in total laparoscopic hysterectomy.

Patients and methods

One-hundred six female patients scheduled for elective total laparoscopic hysterectomy were randomly divided into saline group (group P) and esketamine group (group S). Group P received induction with normal saline, propofol, sufentanil, midazolam, and rocuronium, while group S received induction with low-dose esketamine (0.25 mg/kg), propofol, sufentanil, midazolam, and rocuronium. Both groups were maintained with intravenous infusions of propofol and remifentanil. The quality of recovery (QoR-40), Numerical Rating Scale (NRS), and Pittsburgh Sleep Index (PSQI) scores were assessed at 8, 24, 48, and 72 h, 7 days, and 30-day post-surgery. Hamilton Depression Scale (HAMD) scores were evaluated at 72 h, 7 days, and 30-day post-surgery. Intraoperative hemodynamics, remifentanil consumption, inflammatory reactions, and adverse reactions were also documented.

Results

Both groups had similar QoR-40 scores at each time point (P > 0.05). Patients in group S had less intraoperative remifentanil use (P < 0.001), less consumption of phenylephrine (P = 0.005), fewer episodes of hypotension (P < 0.001), and shorter extubation time and stay in postanesthesia care unit (PACU) (P < 0.001). The NRS scores after extubation (P = 0.007), 8 h (P = 0.027) and 48 h (P = 0.016) after surgery, and the postoperative NLR (P = 0.003) and postoperative 24-h PSQI score (P = 0.024) were significantly lower in group S. The mean blood pressure (MBP) was higher at 10 min after incubation (T3) (P < 0.001). The heart rate (HR) was faster at 3 min (T1) (P = 0.005), 10 min (T3) (P = 0.023), and 30 min (T4) (P = 0.014) after incubation and complete end of surgery (T5) (P = 0.010) in group S. Multiple linear regression analyses demonstrated that higher education was associated with better recovery (P < 0.05).

Conclusion

In patients undergoing total laparoscopic hysterectomy, one injection of low-dose esketamine at anesthesia induction did not affect QoR-40 scores. However, esketamine stabilized intraoperative hemodynamics, decreased intraoperative opioid requirements, and shortened postoperative extubation time and PACU stay. It also alleviated postoperative inflammatory response and pain without causing adverse effects.