ArticleFrontiers in pharmacology2025
Effectiveness and safety of esketamine in laparoscopic surgery patients: a systematic review and meta-analysis of randomized controlled trials.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Low-dose esketamine for postoperative fatigue after gynecological laparoscopic surgery: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Esketamine hydrochloride in the management of moderate-to-severe depressive symptoms in patients undergoing multiple wound repair surgeries: A multi-centre randomized, double-blind, placebo-controlled trial.Clinical and translational medicine · 2026Trial
- 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
- Intraoperative esketamine infusion and postoperative sleep quality after shoulder arthroscopy: a randomized controlled trial.Frontiers in pharmacology · 2026Article
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Authors and funding
5 authors.
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Abstract
Objectives: Laparoscopic surgery is commonly performed, with perioperative treatments aimed at minimizing its impact on patients. Esketamine, known for its antidepressant mechanism, has gained attention as an anesthetic. This review evaluates its effectiveness and safety in laparoscopic surgery patients, since existing trials report conflicting results. Patients and methods: A systematic search across eight databases identified RCTs (Randomized Controlled Trials) on esketamine's effects in laparoscopic surgery patients. Outcomes assessed included VAS (Visual Analog Scale), AIS (Athens Insomnia Scale), NRS (Numeric Rating Scale), QoR-15 (Postoperative Quality of Recovery), remifentanil consumption, ICFS-10 (Inpatient Cognitive Function Scale) scores, and plasma BDNF (brain-derived neurotrophic factor) concentrations. The study is registered in PROSPERO (CRD42025630085). Results: Fifteen studies involving 1,553 participants were included. Esketamine reduced postoperative VAS (SMD: -0.47; 95% CI [-0.89, -0.05]; P = 0.027) and NRS scores (SMD: -0.36; 95% CI [-0.70, -0.01]; P = 0.042). It also decreased AIS scores on the first (SMD: -0.55; 95% CI [-1.03, -0.07]; P = 0.026) and third days (SMD: -0.85; 95% CI [-1.42, -0.29]; P = 0.003), and ICFS-10 scores (first: SMD: -0.55; third: SMD: -0.62). Additionally, esketamine lowered remifentanil consumption (SMD: -0.58; P = 0.003) and infusion rate (SMD: -0.40; P = 0.001), while increasing plasma BDNF concentrations (SMD: 1.19; P = 0.044). Sensitivity analysis confirmed the stability of these results. Conclusion: Esketamine alleviates postoperative pain, reduces remifentanil and opioid consumption, improves sleep quality and recovery, mitigates postoperative fatigue, and increases plasma BDNF concentrations in laparoscopic surgery patients. Nevertheless, this meta-analysis still has certain limitations, most notably the high heterogeneity of the studies incorporated and the limited geographical coverage of the research sites. Further studies are needed to confirm these findings and support its use in improving perioperative outcomes.
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