Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial
Background Gynecologic laparotomy surgery often leads to moderate to severe pain. Effective analgesia is essential for patient postoperative recovery. We aimed to evaluate the effect of low-dose esketamine on quality of recovery when used as part of multimodal analgesia in patients undergoing open g...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2546675 |
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| author | Zhi-Yu Geng Yan Zhang Xin Yan Jun Hu Ran Cui Lin-Lin Song Hui-Cheng Song |
| author_facet | Zhi-Yu Geng Yan Zhang Xin Yan Jun Hu Ran Cui Lin-Lin Song Hui-Cheng Song |
| author_sort | Zhi-Yu Geng |
| collection | DOAJ |
| description | Background Gynecologic laparotomy surgery often leads to moderate to severe pain. Effective analgesia is essential for patient postoperative recovery. We aimed to evaluate the effect of low-dose esketamine on quality of recovery when used as part of multimodal analgesia in patients undergoing open gynecologic surgery.Methods 140 female patients undergoing gynecologic laparotomy under general anesthesia were randomly assigned to receive intraoperative infusion of either 0.25 mg/kg/h esketamine (study group) or an equivalent volume of normal saline (control group). The primary outcome was quality of recovery at 24 h postoperatively, assessed using the 40-item quality of recovery questionnaire (QoR-40). Secondary outcomes included morphine consumption, pain scores, functional outcomes, adverse events, postoperative depressive symptom, chronic pain, and health-related quality of life.Results The global QoR-40 score at 24 h was not significantly different between the two groups [study group, 178 (165–186); control group, 175 (164–186); median difference, 2; 95% CI, −3 to 7; p = 0.467). Secondary outcomes were comparable between the two groups. More patients in the study group had extubation time ≥ 10min (15.7% vs. 2.9%; p= 0.009) and were over sedated (25.7 vs. 4.3%, p < 0.001) during post-anesthesia care unit stay.Conclusions Intraoperative infusion of 0.25 mg/kg/h esketamine had no additional benefit on early quality of recovery when used as part of multimodal analgesic regimen in patients undergoing open gynecologic surgery. Future investigations are needed to determine the optimal dosing regimen and identify subgroups of gynecologic patients who would benefit most from esketamine.Trial registration Chinese Clinical Trial Registry; ChiCTR 2200061021. |
| format | Article |
| id | doaj-art-bee4b8d242374a0c841e15cc7d2abe1d |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-bee4b8d242374a0c841e15cc7d2abe1d2025-08-20T03:04:57ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2546675Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trialZhi-Yu Geng0Yan Zhang1Xin Yan2Jun Hu3Ran Cui4Lin-Lin Song5Hui-Cheng Song6Department of Anesthesiology, Peking University First Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, Peking University First Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, Peking University First Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, Peking University First Hospital, Beijing, ChinaDepartment of Obstetrics and Gynecology, Peking University First Hospital, Beijing, ChinaDepartment of Anesthesiology, Peking University First Hospital, Beijing, ChinaSchool of Public Health, Capital Medical University, Beijing, ChinaBackground Gynecologic laparotomy surgery often leads to moderate to severe pain. Effective analgesia is essential for patient postoperative recovery. We aimed to evaluate the effect of low-dose esketamine on quality of recovery when used as part of multimodal analgesia in patients undergoing open gynecologic surgery.Methods 140 female patients undergoing gynecologic laparotomy under general anesthesia were randomly assigned to receive intraoperative infusion of either 0.25 mg/kg/h esketamine (study group) or an equivalent volume of normal saline (control group). The primary outcome was quality of recovery at 24 h postoperatively, assessed using the 40-item quality of recovery questionnaire (QoR-40). Secondary outcomes included morphine consumption, pain scores, functional outcomes, adverse events, postoperative depressive symptom, chronic pain, and health-related quality of life.Results The global QoR-40 score at 24 h was not significantly different between the two groups [study group, 178 (165–186); control group, 175 (164–186); median difference, 2; 95% CI, −3 to 7; p = 0.467). Secondary outcomes were comparable between the two groups. More patients in the study group had extubation time ≥ 10min (15.7% vs. 2.9%; p= 0.009) and were over sedated (25.7 vs. 4.3%, p < 0.001) during post-anesthesia care unit stay.Conclusions Intraoperative infusion of 0.25 mg/kg/h esketamine had no additional benefit on early quality of recovery when used as part of multimodal analgesic regimen in patients undergoing open gynecologic surgery. Future investigations are needed to determine the optimal dosing regimen and identify subgroups of gynecologic patients who would benefit most from esketamine.Trial registration Chinese Clinical Trial Registry; ChiCTR 2200061021.https://www.tandfonline.com/doi/10.1080/07853890.2025.2546675Esketaminegynecologicmultimodal analgesiapostoperativequality of recovery |
| spellingShingle | Zhi-Yu Geng Yan Zhang Xin Yan Jun Hu Ran Cui Lin-Lin Song Hui-Cheng Song Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial Annals of Medicine Esketamine gynecologic multimodal analgesia postoperative quality of recovery |
| title | Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial |
| title_full | Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial |
| title_fullStr | Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial |
| title_full_unstemmed | Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial |
| title_short | Intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery: a double-blinded, parallel-group, placebo- controlled trial |
| title_sort | intraoperative low dose esketamine on postoperative quality of recovery in patients undergoing open gynecologic surgery a double blinded parallel group placebo controlled trial |
| topic | Esketamine gynecologic multimodal analgesia postoperative quality of recovery |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2546675 |
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