Evidence map›Paper›PMID 42893989›Full record

Trial reportTranslational psychiatry2026

Dual benefit of esketamine-based opioid-free anesthesia on postoperative pain and mental health outcomes in patients undergoing bariatric surgery: a randomized controlled trial.

Chunxia Huang, Zichun Guan, Sheng Wang, Wu Liu, Fuqiang Zu, Jinkai Sun, Feng Geng, Rui Li, Gordon Tin Chun Wong, Ye Zhang and 5 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Translational psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Chunxia Huang *Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China.
Zichun Guan *Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder, Chinese Academy of Medical Sciences, Beijing, China.
Sheng Wang *Department of Health Sciences and Technology, Anhui University, Hefei, China.
Wu Liu *Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China.
Fuqiang ZuDepartment of General Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Jinkai SunSecond clinical college, Anhui Medical University, Hefei, China.
Feng GengDepartment of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Rui LiDepartment of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China.
Gordon Tin Chun WongDepartment of Anaesthesiology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China, Hong Kong, China.
Ye ZhangDepartment of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China.
Andreas ReifGoethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.ORCID http://orcid.org/0000-0002-0992-634X
Dongxin WangDepartment of Anaesthesiology, Peking University First Hospital, Beijing, China.
Benli JiaDepartment of General Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China. jbl1985@163.com.
Lin LuPeking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China. linlu@bjmu.edu.cn.ORCID http://orcid.org/0000-0003-0742-9072
Qi XueDepartment of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital of Anhui Medical University, Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China. xueqi@ahmu.edu.cn.ORCID http://orcid.org/0000-0001-5644-1874

Funding

National Natural Science Foundation of China (National Science Foundation of China) 82300945
6 · The paper itself

Abstract

Patients with morbid obesity are at a high risk of comorbid depressive and anxiety symptoms. While bariatric surgery is an effective treatment, conventional opioid-based anesthesia carries significant perioperative risks. Opioid-free anesthesia (OFA) presents a safer alternative. Esketamine, known for its dual analgesic and rapid antidepressant effects, is a promising component of OFA. However, clinical evidence supporting its simultaneous benefits for both physical and psychological recovery in bariatric patients remains limited. In this double-blind, randomized clinical trial, patients scheduled for laparoscopic sleeve gastrectomy were randomly assigned (1:1) to receive either esketamine-based anaesthesia or opioid-based anaesthesia with remifentanil during surgery. The co-primary outcomes were postoperative pain intensity within the first 24 h and mental health status at three months after surgery. Secondary outcomes included pharmacokinetics of esketamine and adverse events. A total of 84 patients were randomized, with 42 allocated to each group. Seventy-four participants (88.1%) completed the 3-month follow-up. Patients in the esketamine group experienced significantly lower postoperative pain intensity (P < 0.01) and a reduced incidence of moderate-to-severe pain (P < 0.05) within 24 h after surgery. Mental health outcomes at 3 months were also significantly better in the esketamine group, and adverse events rate did not differ significantly. Pharmacokinetic analysis showed that plasma esketamine concentrations increased rapidly during infusion, with early formation of the active metabolite (S)-norketamine. Compared to opioid-based anaesthesia, esketamine-based opioid-free anaesthesia was associated with improved postoperative analgesia and better mental health outcomes in morbidly obese patients undergoing bariatric surgery, without increasing adverse events.

Indexed as

Bariatric SurgeryKetamineObesity, MorbidPostoperative PainAdultAnalgesics, OpioidDouble-Blind MethodFemaleHumansMaleMiddle AgedPain MeasurementRemifentanilAnalgesics, OpioidEsketamineKetamineRemifentanil

Identifiers

PMID42893989
PMCPMC13677711

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.