Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial
Abstract Introduction This study aims to evaluate the efficacy of esketamine on postoperative recovery quality after laparoscopic bariatric surgery. Methods Patients (n = 74) scheduled for laparoscopic bariatric surgery were randomly divided into two groups: the esketamine group (group E: 0.5 mg/kg/...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-05-01
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| Series: | Pain and Therapy |
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| Online Access: | https://doi.org/10.1007/s40122-023-00519-9 |
| _version_ | 1797795884541411328 |
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| author | Jingyue Zhang Fan Wang Jingjing Dang Huiwen Zheng Baiqing Ren Chao Liu Ronghua Zuo Rui Wang Tianya Liu Zhiping Wang |
| author_facet | Jingyue Zhang Fan Wang Jingjing Dang Huiwen Zheng Baiqing Ren Chao Liu Ronghua Zuo Rui Wang Tianya Liu Zhiping Wang |
| author_sort | Jingyue Zhang |
| collection | DOAJ |
| description | Abstract Introduction This study aims to evaluate the efficacy of esketamine on postoperative recovery quality after laparoscopic bariatric surgery. Methods Patients (n = 74) scheduled for laparoscopic bariatric surgery were randomly divided into two groups: the esketamine group (group E: 0.5 mg/kg/h infusion, i.e., 0.2 mL/kg/h) or the control group (group C: 0.2 mL/kg/h normal saline infusion). The infusions were stopped 20 min before the end of the procedure. The primary outcome was the Quality of Recovery-40 (QoR-40) score on postoperative day 1 (POD 1). The secondary outcomes included QoR-40 scores on PODs 2 and 7, Numeric Rating Scale (NRS) on PODs 1, 2, and 7, time to extubation, additional postoperative analgesic use, length of hospital stay, and time to first exhaust. Additonally, the safety indices were also recorded, including hemodynamic profile, perioperative anesthesia index (Ai), utilization of vasoactive drugs or urapidil, and side effects. Results All in all, 70 of the 74 patients completed the study, 35 in each group. The difference of QoR-40 scores on POD 1 was both statistically and clinically significant [difference 7.21, 95% confidence interval (CI) 5.17, 9.25, p < 0.001]. The difference of QoR-40 on POD 2 was statistically significant but clinically insignificant (difference 4.81, 95% CI 2.69, 6.92, p < 0.001). The difference of NRS scores on POD 1 was statistically significant (difference −1.23, 95% CI −2.36, −0.10, p = 0.033). Compared with group C, group E had a lower utilization rate of phenylephrine and higher Ai values (p < 0.05). There was no statistical difference between the two groups on other measures. Conclusion Continuous ketamine infusion seems to be safe and well tolerated in laparoscopic bariatric surgery. It improved the quality of postoperative recovery and reduced pain on POD 1. In spite of the increased Ai value during the surgery, it also provided better hemodynamics with less usage of phenylephrine. |
| first_indexed | 2024-03-13T03:24:46Z |
| format | Article |
| id | doaj.art-e91ff9b084a04053b0af62cb6fb740df |
| institution | Directory Open Access Journal |
| issn | 2193-8237 2193-651X |
| language | English |
| last_indexed | 2024-03-13T03:24:46Z |
| publishDate | 2023-05-01 |
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| series | Pain and Therapy |
| spelling | doaj.art-e91ff9b084a04053b0af62cb6fb740df2023-06-25T11:08:21ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2023-05-0112497999210.1007/s40122-023-00519-9Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled TrialJingyue Zhang0Fan Wang1Jingjing Dang2Huiwen Zheng3Baiqing Ren4Chao Liu5Ronghua Zuo6Rui Wang7Tianya Liu8Zhiping Wang9Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityDepartment of Anesthesiology, The Affiliated Hospital of Xuzhou Medical UniversityAbstract Introduction This study aims to evaluate the efficacy of esketamine on postoperative recovery quality after laparoscopic bariatric surgery. Methods Patients (n = 74) scheduled for laparoscopic bariatric surgery were randomly divided into two groups: the esketamine group (group E: 0.5 mg/kg/h infusion, i.e., 0.2 mL/kg/h) or the control group (group C: 0.2 mL/kg/h normal saline infusion). The infusions were stopped 20 min before the end of the procedure. The primary outcome was the Quality of Recovery-40 (QoR-40) score on postoperative day 1 (POD 1). The secondary outcomes included QoR-40 scores on PODs 2 and 7, Numeric Rating Scale (NRS) on PODs 1, 2, and 7, time to extubation, additional postoperative analgesic use, length of hospital stay, and time to first exhaust. Additonally, the safety indices were also recorded, including hemodynamic profile, perioperative anesthesia index (Ai), utilization of vasoactive drugs or urapidil, and side effects. Results All in all, 70 of the 74 patients completed the study, 35 in each group. The difference of QoR-40 scores on POD 1 was both statistically and clinically significant [difference 7.21, 95% confidence interval (CI) 5.17, 9.25, p < 0.001]. The difference of QoR-40 on POD 2 was statistically significant but clinically insignificant (difference 4.81, 95% CI 2.69, 6.92, p < 0.001). The difference of NRS scores on POD 1 was statistically significant (difference −1.23, 95% CI −2.36, −0.10, p = 0.033). Compared with group C, group E had a lower utilization rate of phenylephrine and higher Ai values (p < 0.05). There was no statistical difference between the two groups on other measures. Conclusion Continuous ketamine infusion seems to be safe and well tolerated in laparoscopic bariatric surgery. It improved the quality of postoperative recovery and reduced pain on POD 1. In spite of the increased Ai value during the surgery, it also provided better hemodynamics with less usage of phenylephrine.https://doi.org/10.1007/s40122-023-00519-9Bariatric surgeryEsketaminePostoperative painPostoperative recoveryQuality of Recovery-40Quality measures |
| spellingShingle | Jingyue Zhang Fan Wang Jingjing Dang Huiwen Zheng Baiqing Ren Chao Liu Ronghua Zuo Rui Wang Tianya Liu Zhiping Wang Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial Pain and Therapy Bariatric surgery Esketamine Postoperative pain Postoperative recovery Quality of Recovery-40 Quality measures |
| title | Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial |
| title_full | Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial |
| title_fullStr | Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial |
| title_full_unstemmed | Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial |
| title_short | Effect of Intraoperative Infusion of Esketamine on Quality of Postoperative Recovery in Patients Undergoing Laparoscopic Bariatric Surgery: A Randomized Controlled Trial |
| title_sort | effect of intraoperative infusion of esketamine on quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery a randomized controlled trial |
| topic | Bariatric surgery Esketamine Postoperative pain Postoperative recovery Quality of Recovery-40 Quality measures |
| url | https://doi.org/10.1007/s40122-023-00519-9 |
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