Effect of low-dose supplemental esketamine infusion on the intraoperative frontal electroencephalography dynamics and postoperative sleep disturbance during gynecological laparoscopic surgery: a double-blind, randomized clinical trial

作者：Yanhong Zhou, Lin Li, Gao Run, Yingjie Yang, Shuo Yan, Qian Wang, Wan Lei, Jianjun Shen, Xinzhong Chen, Xiaowei Qian, Lili Xu · 发表于：International Journal of Surgery · 年份：2025 · DOI：10.1097/js9.0000000000002836 · 被引用次数：15 · 研究领域：Anesthesia and Sedative Agents、Nausea and vomiting management、Sleep and Wakefulness Research

BACKGROUND: Recent studies have shown that intraoperative administration of subanesthetic esketamine not only induced an active prefrontal electroencephalogram (EEG) pattern during sevoflurane anesthesia, but also improve the sleep quality in women after laparoscopic surgery, but the latter regarding the specific mechanism of the EEG frontal power band activity remains unknown. Our research aimed to investigate the impact of low-dose supplemental esketamine infusion on the incidence of postoperative sleep disturbance and the intraoperative frontal EEG characteristics in patients undergoing gynecologic laparoscopic surgery under general anesthesia. METHODS: Ninety-eight patients scheduled for gynecological laparoscopic surgery under general anesthesia were randomly assigned to receive either a continuous infusion of 1 mg · kg -1 · h -1 esketamine or an equivalent volume of normal saline for 30 minutes. The primary outcome was the incidence of postoperative sleep disturbance on postoperative day 1, defined as a numeric rating scale (NRS) score of subjective sleep quality ≥6. Secondary outcomes included the changes of frontal EEG patterns and EEG frequency spectrum indices, NRS scores of subjective sleep quality, and the incidence of postoperative sleep disturbance on postoperative days 3 and 7. RESULTS: All 98 patients completed the study. The incidence of postoperative sleep disturbance on postoperative day 1 was significantly lower in the esketamine group compared to the cont...