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Anesthesiology and Perioperative Science

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Open Access 01-03-2024 | Esketamine | Original Research

Low-dose esketamine improves acute postoperative pain in patients undergoing thoracoscopic surgery

Authors: Qing-wei Zhang, Xin Wang, Zhong-yun Wang, He-liang Sun

Published in: Anesthesiology and Perioperative Science | Issue 1/2024

Abstract

Purpose

The current study was designed to investigate the analgesic effect of esketamine on patients underwent thoracoscopic surgery and the underlying mechanism.

Methods

In this randomized, double blind, placebo-controlled study, 60 patients scheduled to undergo thoracoscopic lobectomy or segmentectomy were randomized to two groups to receive esketamine (group ESK) or saline (group SAL), respectively. 0.25 mg·kg⁻¹ esketamine was given in group ESK for induction of anesthesia, and 0.12 mg·kg⁻¹·h⁻¹ esketamine for intraoperative maintenance. Group SAL received an equal volume of saline. The primary outcomes were the visual analogue scale (VAS) pain scores at rest and deep cough state which evaluated at departure from post-anesthesia care unit (PACU) (T1), 6 h, 24 h and 48 h after surgery (T2–T4). The secondary outcomes included the levels of white blood cell (WBC) count, absolute neutrophil count (ANC), interleukin-6 (IL-6), procalcitonin (PCT), anxiety/depression scores at T3, oxygen saturation (SpO2), and adverse reactions.

Results

Esketamine significantly decreased both rest and cough VAS pain scores at T1, and rest pain scores at T1, T2 and T4. Patients in ESK group had significantly lower WBC and ANC levels than SAL group, while the alteration of IL-6 and PCT levels between groups showed no significance. The anxiety scores of patients in both groups were significantly decreased after surgery. However, the depression scores of patients in ESK group did not decrease after surgery when compared with the preoperation. The postoperative SpO2 and the incidence of adverse reaction including postoperative nausea, vomiting, dizziness and dissociative symptom showed no significant difference between two groups (p > 0.05).

Conclusion

Esketamine can alleviate the acute postoperative pain of patients undergoing thoracoscopic surgery without increasing adverse reactions, and the underlying mechanism may be associated with the reduction of postoperative inflammation.

Trial registration

Registered at Chinese Clinical Trial Registry on February 7, 2022 (ChiCTR 2200056524).

Graphical Abstract

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Title: Low-dose esketamine improves acute postoperative pain in patients undergoing thoracoscopic surgery
Authors: Qing-wei Zhang
Xin Wang
Zhong-yun Wang
He-liang Sun
Publication date: 01-03-2024
Publisher: Springer Nature Singapore
Keywords: Esketamine
Esketamin
Ketamine
Mood Disorders
Affective Disorder
Anxiety
Published in: Anesthesiology and Perioperative Science / Issue 1/2024
Electronic ISSN: 2731-8389
DOI: https://doi.org/10.1007/s44254-023-00039-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Low-dose esketamine improves acute postoperative pain in patients undergoing thoracoscopic surgery

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Graphical Abstract

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