Trial reportBMC anesthesiology2025
The impact of intraoperative esketamine infusion on postoperative sleep in patients undergoing general surgery.
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 1 paper, 1 of them a synthesis that pooled it.
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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.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Perioperative esketamine for prevention of postoperative sleep disturbance after anesthesia: a systematic review and meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2026Pooled it
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9 authors.
Funding
Abstract
objectiveMajor abdominal surgery frequently induces circadian sleep-wake disturbances, characterized by increased daytime rapid eye movement (REM) sleep and prolonged nocturnal wakefulness. This study investigated the effects of perioperative continuous esketamine infusion (0.3 mg/kg/h) on postoperative sleep disturbance in patients under general anesthesia. Intraoperative electroencephalography (EEG) monitoring was implemented with focused analysis of relative wavelength frequencies.
methods. Patients undergoing surgery received a continuous intraoperative esketamine infusion at a dose of 0.3 mg/kg/h. Concurrent electroencephalography (EEG)monitoring was performed, with the analysis specifically focusing on relative power percentages of the EEG signal.Preoperatively, levels of melatonin (quantified using mass spectrometry), Interleukin-6 (IL-6), and C-Reactive Protein (CRP)were measured.Postoperative sleep quality was then assessed on days 1 and 3 using the Athens Insomnia Scale (AIS), where a score > 6 was defined as sleep disturbance.
resultsThe esketamine group exhibited significantly lower rates of sleep disturbance on postoperative day 1 (37/75 [49.3%] vs. 19/75 [25.3%];P = 0.002) and day 3 (27/75 [36.0%] vs. 14/75 [18.7%];P = 0.017). Significant intergroup differences in acute postoperative pain were observed. The EEG analysis demonstrated that the slow-wave activity composite index (PCI) serves as a robust predictor for postoperative sleep disturbance risk(OR = 0.25, 95% CI:0.139-0.479;P < 0.001).Multivariate logistic regression identified independent predictors of postoperative sleep disturbance (PSD): Esketamine administration (OR 0.274; 95% CI 0.088-0.854);Preoperative melatonin levels (per-unit increase: OR 1.039; 95% CI 1.013-1.065);Preoperative HADS-A anxiety score (OR 1.396; 95% CI 1.075-1.813);preoperative IL-6 levels (OR 1.274; 95% CI 1.025-1.583);Postoperative pain score (OR 2.340; 95% CI 1.483-3.692);PC1 (OR 0.25, 95% CI: 0.139-0.479).
conclusionPerioperative esketamine administration significantly reduces postoperative sleep disturbance (PSD) incidence and early postoperative pain severity. Independent risk factors for PSD include preoperative melatonin deficiency, anxiety symptoms (HADS-A), preoperative IL-6 elevation, and acute postoperative pain. Crucially, the slow-wave activity composite index (PCI)-reflecting esketamine-induced prefrontal delta synchronization (δ/α ratio + Delta power)-emerges as a robust predictor of PSD risk (OR = 0.25, 95% CI: 0.139-0.479;P < 0.001). REGISTRY: ChiCTR Trial Registration Number (TRN): ChiCTR2400092868 Registration date: 25 November 2024.
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