Effect of S-ketamine on Postoperative Quality of Recovery in Patients Undergoing Video-Assisted Thoracic Surgery

Chen, Xiang; Wang, Han; Diao, Mengmeng; Hao, Jian

doi:10.1053/j.jvca.2022.04.028

Cited by 31 publications

(17 citation statements)

References 38 publications

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“… 32 Cheng et al indicated that S-ketamine administration improved quality of postoperative recovery, postoperative analgesia, and depression after operation in patients undergoing video-assisted thoracic surgery. 19 In our study, we found that low-dose esketamine infusion was higher total QoR-15 scores on POD1 and POD3. Moreover, our results also demonstrated that high-dose esketamine infusion had the highest overall QoR-15 scores on POD1 and POD3.…”

Section: Discussionsupporting

confidence: 50%

“…[14][15][16] In addition, several studies showed that esketamine promoted postoperative recovery by reducing postoperative pain, and there was no significant difference in the incidence of postoperative nausea and vomiting. [17][18][19] Therefore, we hypothesized that the esketamine infusion provides better the quality of recovery in patients undergoing modified radical mastectomy.…”

Section: Introductionmentioning

confidence: 99%

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Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

Zhu¹,

Xu²,

Ju³

et al. 2022

DDDT

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Purpose This study aims to investigate the effects of the different doses of esketamine on postoperative quality of recovery in patients undergoing modified radical mastectomy. Methods Ninety-nine female patients were randomly allocated to three groups: the low-dose esketamine group (group E 1 ) (0.5 mg/kg loading, 2 µg/kg/h infusion), the high-dose esketamine group (group E 2 ) (0.5 mg/kg loading, 4 µg/kg/h infusion), the control group (group C) (received normal saline). The primary outcome was the quality of recovery-15 (QoR-15) scores on postoperative day 1 (POD1) and days 3 (POD3). The secondary outcomes were the sleep quality scores on POD1, bispectral index (BIS) value at 10, 30, and 60 min after operation, numeric rating scale (NRS) pain scores within 24 h after surgery, nausea, vomiting, drowsiness, nightmare, and intraoperative awareness. Results The total QoR-15 scores were higher in group E 1 and group E 2 than in group C on POD1 and POD3 ( P <0.05). The sleep quality scores on POD1 and BIS value at 10, 30, and 60 min after operation were higher in group E 1 and group E 2 than in group C ( P <0.05). The NRS pain scores at 2, 4 and 6 h after surgery in group E 1 and at 2, 4, 6, 12 and 24 h after surgery in group E 2 were lower than in group C ( P <0.05). The NRS pain scores at 6, 12 and 24 h after surgery in group E 2 were lower than in group E 1 ( P <0.05). The incidence of drowsiness was higher in group E 1 and group E 2 than in group C ( P <0.05). Conclusion Esketamine infusion improved to some extent the quality of recovery on POD1 and POD3 in patients undergoing modified radical mastectomy, especially 4 µg/kg/h esketamine was better, but the BIS value and incidence of drowsiness were significantly increased.

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

Zhu¹,

Xu²,

Ju³

et al. 2022

DDDT

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“…Esketamine is theoretically more analgesic, and nonetheless, the actual analgesic effect of esketamine remains controversial ( 25 , 31 , 32 ). Cheng et al ( 33 ) reported that esketaminea (bolus of 0.25 mg/kg, followed by an infusion of 0.125 mg/kg/h until 15 min before the end of the surgical procedure) improved the quality of rehabilitation in patients undergoing video-assisted thoracic surgery (VATS), and also improved postoperative analgesia and postoperative depression. Another study of the effects of esketamine sedation on hydrostatic reduction of intussusception ketamine ( 34 ) found insufficient evidence for a higher success rate, lower relapse rate, shorter duration, and shorter hospital stay with esketamine compared with morphine analgesia.…”

Section: Discussionmentioning

confidence: 99%

Is esketamine-based opioid-free anesthesia more superior for postoperative analgesia in obstructive sleep apnea patients undergoing bariatric surgery? A study protocol

Guo

Chen²,

Gao³

et al. 2022

Front. Med.

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IntroductionOpioid-free anesthesia (OFA) can certainly prevent nausea and vomiting after bariatric surgery (BS), but its postoperative analgesic effect is still controversial. Obstructive sleep apnea (OSA) is a prominent feature of morbid obesity in BS and accounts for a very high proportion, which significantly increases the difficulty of patients’ airway management. Those patients will be more representative and highlight the advantages of OFA. It is not clear whether esketamine can play a more prominent role in OFA for postoperative analgesia. Therefore, this study aims to explore the postoperative analgesic effect of esketamine-based OFA on BS patients with OSA.Methods and analysisThis single-center, prospective, randomized, controlled, single-blind study is planned to recruit 48 participants to undergo BS from May 2022 to April 2023. Patients will be randomly assigned to the OFA group and opioid-based anesthesia (OBA) group in a ratio of 1:1. The primary outcome is the Numeric Rating Scale (NRS) at different times postoperatively. Secondary outcomes include analgesic intake, the incidence and severity of postoperative nausea and vomiting (PONV), Leiden Surgical Rating Scale (L-SRS), postoperative agitation and chills, PACU stay time, EuroQol five-dimensional questionnaire (EQ-5D), length of hospital stay, intraoperative awareness, and hemodynamically unstable treatments.DiscussionThe results of this study may explain the analgesic effect of esketamine-based OFA on patients undergoing BS combined with OSA, and provide evidence and insight for perioperative pain management.Ethics and disseminationThis study is initiated by the Ethics Committee of The First Affiliated Hospital of Shandong First Medical University [YXLL-KY-2022(035)]. The trial results will be published in peer-reviewed journals and at conferences.Clinical trial registration[https://clinicaltrials.gov/ct2/show/NCT05386979], identifier [NCT 05386979].

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“…However, even when ketamine is used in low doses, ketamine's side efects (mainly visual and auditory hallucinations, depersonalisation, and changes in body perception) may infuence the patient's perception of their quality of recovery [6]. Few studies have assessed the impact of intraoperative administration of ketamine on the quality of recovery, and the majority have used the 40-item Quality of Recovery (QoR-40) Questionnaire [7,11,12]. Terefore, this study aimed to evaluate if ketamine administration during anaesthesia induction impacts the quality of recovery after laparoscopic surgery under fentanyl-halogenatedbased anaesthesia using the Portuguese version of the QoR-15 Questionnaire.…”

Section: Introductionmentioning

confidence: 99%

Impact of Ketamine on Quality of Recovery after Laparoscopic Surgery: A Single-Centre Single-Blinded Trial Using the QoR-15 Questionnaire

Pereira

Graça

Fonseca

et al. 2023

Anesthesiology Research and Practice

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Background. The quality of recovery is a cluster of patient-related outcomes that emphasise not only pain but different physical and emotional dimensions. Traditionally, ketamine is used to improve postoperative analgesia and avoid opioid consumption and opioid-related side effects. Objective. The present study sought to evaluate if intraoperative ketamine administration (as a part of multimodal analgesia) influences the quality of recovery after laparoscopic surgery. Design. A prospective two-armed, single-blinded trial. Settings. Tertiary single-centre trial between July 2021 and January 2022. Patients. From the 146 patients initially admitted to the study, 127 patients were enrolled, 60 in the ketamine group (group K) and 67 in the control group (group NK). Intervention. Both groups received a rigid intraoperative anaesthesia protocol; furthermore, in group K, 0.5 mg/kg of the ideal body weight of ketamine was administered. Main Outcome Measures. The primary outcome was to evaluate the effect of ketamine administration on the postoperative quality of recovery using the Portuguese version of the Quality of Recovery-15 (QoR-15) Questionnaire 24 h after surgery. The total score and minimal clinically significant difference (MCID) of the QoR-15 were compared. Other variables were also assessed such as the presence of emergence delirium (ED), the Numeric Rating Scale (NRS) for pain, and the presence of postoperative nausea and vomiting (PONV). Results. A total of 127 patients were allocated to the study groups, 60 in group K and 67 in group NK. Regarding the primary outcome, no differences were found in individual categories (15 items) and in the total score of QoR-15 ( p = 0.214 ). Concerning improvement (MCID ≥ 8) or worsening (MCID ≤ 8) in quality of recovery, no difference was found between the groups (24 vs. 32 and 6 vs. 6; p = 0.776 ). Finally, no difference was found in secondary postoperative outcomes including ED ( p = 0.55 ), NRS ( p = 0.401 ), and PONV ( p = 0.55 ). Conclusion. In this study, the administration of ketamine in laparoscopic surgery had no impact on the quality of recovery 24 h after surgery. This trial is registered with NCT03724019.

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Effect of S-ketamine on Postoperative Quality of Recovery in Patients Undergoing Video-Assisted Thoracic Surgery

Cited by 31 publications

References 38 publications

Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

Is esketamine-based opioid-free anesthesia more superior for postoperative analgesia in obstructive sleep apnea patients undergoing bariatric surgery? A study protocol

Impact of Ketamine on Quality of Recovery after Laparoscopic Surgery: A Single-Centre Single-Blinded Trial Using the QoR-15 Questionnaire

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