Trial reportBMC anesthesiology2025
Esketamine attenuates hemodynamic oscillations during anesthesia induction in elderly gastrointestinal surgical patients: a randomized trial.
Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Efficacy and Safety of Esketamine in Patients Undergoing Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2026Review
- Knowledge, attitude and practice of pre-operative fasting in gastrointestinal surgery: Post-operative complications.Bioinformation · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundPatients undergoing gastrointestinal tumor surgery face heightened susceptibility to hemodynamic instability during anesthesia induction, a risk further exacerbated by preoperative fasting. Oscillatory blood pressure fluctuations increase perioperative risks. Esketamine's sympathomimetic properties may counteract propofol-induced hypotension. This study aimed to evaluate the impact of adjunctive esketamine on hemodynamic instability incidence during induction.
methodsThis prospective, double-blind RCT (ChiCTR2200060641, registered on June 6, 2022) enrolled ASA I-III patients (18-75 years) scheduled for gastrointestinal tumor surgery at Foshan First People's Hospital (Jun 2022-May 2023). Patients were randomized 1:1 to receive IV esketamine (0.2 mg/kg) or saline placebo during induction. Anesthesia was induced with propofol (1.5-2.0 mg/kg), sufentanil (0.2 µg/kg), and cisatracurium (0.3 mg/kg). The primary outcome was the incidence of hemodynamic instability (defined as hypertension [MAP > 20% baseline], hypotension [MAP < 65 mmHg or > 20% decrease], tachycardia [HR > 100 bpm], bradycardia [HR < 50 bpm], or vasopressor use) from induction to 5 min post-intubation. The secondary outcomes included intraoperative ephedrine consumption, postoperative recovery time, extubation time, duration of post-anaesthesia care unit (PACU) stay, emergence agitation, cough during intubation, and other adverse effects.
resultsThe incidence of hemodynamic instability was significantly lower in the esketamine group than in the control group during induction (29.3% vs. 55.9%; OR = 0.33, 95% CI: 0.18-0.60; P < 0.001). Specifically, esketamine reduced hypotension (27.2% vs. 44.1%; P = 0.016) and hypertension (3.3% vs. 12.9%; P = 0.016). Ephedrine use was lower (12.0% vs. 24.7%; P = 0.025). CO was preserved in the esketamine group but declined significantly in the control group post-induction (P < 0.05). Cough incidence was reduced with esketamine (8.7% vs. 32.3%; P < 0.001). No differences existed in recovery times, emergence agitation, or PONV.
conclusionsAdjunctive low-dose esketamine (0.2 mg/kg) during propofol-based induction significantly attenuates hemodynamic instability and preserves cardiac output in gastrointestinal surgery patients, without delaying recovery. This approach enhances cardiovascular safety during high-risk induction.
trial registrationThis study was registered with the Chinese Clinical Trial Registry (ChiCTR2200060641) on June 6, 2022.
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