Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail
Objective: Opioid-sparing anesthesia reduces intraoperative use of opioids and postoperative adverse reactions. The current study investigated the effect of esketamine-based opioid-sparing anesthesia on total laparoscopic hysterectomy patients' recovery. Methods: Ninety patients undergoing tota...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
|
| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024009721 |
| _version_ | 1797304525723271168 |
|---|---|
| author | Jialei Liu Jiangwen Yin Jieting Yin Menghan Zhou Long Chen Xiwei Dong Yan Li |
| author_facet | Jialei Liu Jiangwen Yin Jieting Yin Menghan Zhou Long Chen Xiwei Dong Yan Li |
| author_sort | Jialei Liu |
| collection | DOAJ |
| description | Objective: Opioid-sparing anesthesia reduces intraoperative use of opioids and postoperative adverse reactions. The current study investigated the effect of esketamine-based opioid-sparing anesthesia on total laparoscopic hysterectomy patients' recovery. Methods: Ninety patients undergoing total laparoscopic hysterectomy were randomly assigned to esketamine-based group (group K) or opioid-based group (group C). The allocation to groups was unknown to patients, surgeons, and postoperative medical staff. The inability to implement blinding for anesthesiologists was due to the distinct procedures followed by the various groups while administering drugs. The QoR-40 and VAS were used to measure recovery quality. Postoperative adverse events, perioperative opioid consumption, and intraoperative hemodynamics were secondary endpoints. Results: There was an absence of notable discrepancy in the baseline data observed between the two groups. The QoR-40 scores exhibited greater values in group K when compared to group C on the first day following the surgical procedure (160.91 ± 9.11 vs 151.47 ± 8.35, respectively; mean difference 9.44 [95 %CI: 5.78–13.11]; P < 0.01). Within 24 h of surgery, the VAS score of group K was lower at rest and during movement. (P < 0.05 for each). Group K had much lower rates of nausea and vomiting within 24 h of surgery. (P < 0.05 for each). Group K received significantly lower total doses of sufentanil and remifentanil than group C. (17.28 ± 2.59 vs 43.43 ± 3.52; 0.51 ± 0.15 vs 1.24 ± 0.24). The proportion of patients who used ephedrine in surgery was higher in group C than in group K (P < 0.05). Conclusions: Esketamine-based opioid-sparing anesthesia strategy is feasible and enhanced recuperation following surgery by decreasing adverse effects associated with opioids and pain scores compared to an opioid-based anesthetic regimen. |
| first_indexed | 2024-03-08T00:10:44Z |
| format | Article |
| id | doaj.art-020309b3dffe4110b3b3979e5057867a |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-08T00:10:44Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-020309b3dffe4110b3b3979e5057867a2024-02-17T06:39:05ZengElsevierHeliyon2405-84402024-02-01103e24941Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trailJialei Liu0Jiangwen Yin1Jieting Yin2Menghan Zhou3Long Chen4Xiwei Dong5Yan Li6Department of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, China; Department of Anesthesiology, Suzhou First People's Hospital, Suzhou, ChinaDepartment of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, ChinaDepartment of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, ChinaDepartment of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, ChinaDepartment of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, ChinaDepartment of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, China; Corresponding author.Department of Anesthesiology, First Affiliated Hospital of Shihezi University, Shihezi, China; Corresponding author.Objective: Opioid-sparing anesthesia reduces intraoperative use of opioids and postoperative adverse reactions. The current study investigated the effect of esketamine-based opioid-sparing anesthesia on total laparoscopic hysterectomy patients' recovery. Methods: Ninety patients undergoing total laparoscopic hysterectomy were randomly assigned to esketamine-based group (group K) or opioid-based group (group C). The allocation to groups was unknown to patients, surgeons, and postoperative medical staff. The inability to implement blinding for anesthesiologists was due to the distinct procedures followed by the various groups while administering drugs. The QoR-40 and VAS were used to measure recovery quality. Postoperative adverse events, perioperative opioid consumption, and intraoperative hemodynamics were secondary endpoints. Results: There was an absence of notable discrepancy in the baseline data observed between the two groups. The QoR-40 scores exhibited greater values in group K when compared to group C on the first day following the surgical procedure (160.91 ± 9.11 vs 151.47 ± 8.35, respectively; mean difference 9.44 [95 %CI: 5.78–13.11]; P < 0.01). Within 24 h of surgery, the VAS score of group K was lower at rest and during movement. (P < 0.05 for each). Group K had much lower rates of nausea and vomiting within 24 h of surgery. (P < 0.05 for each). Group K received significantly lower total doses of sufentanil and remifentanil than group C. (17.28 ± 2.59 vs 43.43 ± 3.52; 0.51 ± 0.15 vs 1.24 ± 0.24). The proportion of patients who used ephedrine in surgery was higher in group C than in group K (P < 0.05). Conclusions: Esketamine-based opioid-sparing anesthesia strategy is feasible and enhanced recuperation following surgery by decreasing adverse effects associated with opioids and pain scores compared to an opioid-based anesthetic regimen.http://www.sciencedirect.com/science/article/pii/S2405844024009721EsketamineOpioid-sparing anesthesiaPostoperative painRecovery |
| spellingShingle | Jialei Liu Jiangwen Yin Jieting Yin Menghan Zhou Long Chen Xiwei Dong Yan Li Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail Heliyon Esketamine Opioid-sparing anesthesia Postoperative pain Recovery |
| title | Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail |
| title_full | Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail |
| title_fullStr | Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail |
| title_full_unstemmed | Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail |
| title_short | Effect of esketamine-based opioid-sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy: A randomized controlled trail |
| title_sort | effect of esketamine based opioid sparing anesthesia strategy on postoperative pain and recovery quality in patients undergoing total laparoscopic hysterectomy a randomized controlled trail |
| topic | Esketamine Opioid-sparing anesthesia Postoperative pain Recovery |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024009721 |
| work_keys_str_mv | AT jialeiliu effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail AT jiangwenyin effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail AT jietingyin effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail AT menghanzhou effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail AT longchen effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail AT xiweidong effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail AT yanli effectofesketaminebasedopioidsparinganesthesiastrategyonpostoperativepainandrecoveryqualityinpatientsundergoingtotallaparoscopichysterectomyarandomizedcontrolledtrail |