Effect of intraoperative low-dose esketamine infusion on postoperative sleep disturbance after laparoscopic cholecystectomy: a randomized clinical trial

作者：Yanan Wu, Yaning Yang, Xiaomei Wang, Li Sun, Yunpeng Hei, Yuhua Zou, Zhenhai Ye, Zhi Yu · 发表于：BMC Anesthesiology · 年份：2025 · DOI：10.1186/s12871-025-03180-1 · 被引用次数：9 · 研究领域：Enhanced Recovery After Surgery、Nausea and vomiting management、Sleep and related disorders

BACKGROUND: Postoperative sleep disturbance (PSD) is a common surgical complication. In this study, we investigated the effect of intraoperative esketamine infusion on the incidence of PSD in patients who underwent laparoscopic cholecystectomy. METHODS: and underwent laparoscopic cholecystectomy. Patients were randomly assigned to esketamine group or placebo group using a random number table method. Patients in the esketamine group received continuous intraoperative infusion of esketamine, 0.5 mg/kg/h while those in the placebo group were given an equal volume of normal saline. The primary outcome was PSD incidence within 1-3 postoperative days (PODs). PSD was defined as numerical rating scale score of 6 or higher or Athens Insomnia Scale score of 6 or higher. Secondary outcomes were postoperative pain (using visual analog scale), intraoperative remifentanil consumption, postoperative adverse reactions, and PSD-related risk factors. RESULTS: Eighty-six patients were randomly assigned to esketamine group (n = 43; mean [SD] age, 47.9 [9.4] years) and placebo groups (n = 43; mean [SD] age, 49.7 [15.1] years). The incidence of PSD in the esketamine group was significantly lower than in the control group on POD 1 (58.1% vs. 81.4%; odds ratio [OR], 0.32 [95%Cl, 0.12-0.84]; P = 0.019) and POD 2 (11.6% vs. 44.2%; OR, 0.17 [95%Cl, 0.06-0.50]; P = 0.001) and POD3 (2.3% vs. 18.6%; OR, 0.10 [95%Cl, 0.01-0.87]; P = 0.035). Postoperative pain score and intraoperative remifentanil consumpti...