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

作者：Jing Zhang, Zheng Niu, Ting Wang, Li Yu, Xinyi Ren, Shurui Zhang, Y. Zhu, Dunyi Qi · 发表于：Perioperative Medicine · 年份：2025 · DOI：10.1186/s13741-025-00567-z · 被引用次数：5 · 研究领域：Nausea and vomiting management、Anesthesia and Sedative Agents、Treatment of Major Depression

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 ...