Trial reportBMC anesthesiology2026
Impact of esketamine-based opioid-free anesthesia on quality of recovery after laparoscopic hysterectomy: a randomized controlled trial using the QoR-40 questionnaire.
Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
objectiveIn patients undergoing laparoscopic hysterectomy, this study compared two anesthetic approaches-esketamine-based opioid-free anesthesia and opioid-based anesthesia-to assess their impact on postoperative recovery quality. PATIENTS AND
methodsThis prospective trial randomly assigned 91 patients undergoing laparoscopic hysterectomy to receive either esketamine-based anesthesia (induction and maintenance with esketamine, without perioperative opioids) or conventional opioid-based anesthesia. The primary endpoint was defined as the Quality of Recovery-40(QoR-40) score measured on postoperative day (POD) 1. Secondary measures comprised the QoR-40 score on POD 3, pain scores after surgery, hemodynamic variables, and adverse events.
resultsOn POD1, compared to the opioid group, the esketamine group exhibited a significantly elevated QoR-40 score (p < 0.001), but scores were similar by POD3 (p = 0.333). The esketamine group experienced a lower rate of postoperative nausea and vomiting (PONV) (17.8% vs. 37.0%, p = 0.040), whereas the two groups had comparable pain scores at every time point measured (all p > 0.05).
conclusionAmong laparoscopic hysterectomy patients, esketamine-based opioid-free anesthesia was linked to higher POD1 QoR-40 scores and fewer PONV events than opioid-based anesthesia. However, given the modest sample size, these preliminary findings warrant confirmation in larger multicenter trials.
trial registrationWe prospectively registered the study protocol in the Chinese Clinical Trial Registry. (ChiCTR2300075661) on September 12, 2023.
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