Drug Design, Development and Therapy (Dec 2022)
Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial
Abstract
Min Zhu, Siqi Xu, Xia Ju, Shengbin Wang, Xitong Yu Department of Anesthesiology, The Anqing Medical Center of Anhui Medical University, The Fifth Clinical Medical College of Anhui Medical University, Anqing, People’s Republic of ChinaCorrespondence: Xia Ju, Department of Anesthesiology, The Anqing Medical Center of Anhui Medical University, The Fifth Clinical Medical College of Anhui Medical University, Anqing, 246003, People’s Republic of China, Tel +86 13685563136, Email [email protected]: 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 E1) (0.5 mg/kg loading, 2 μg/kg/h infusion), the high-dose esketamine group (group E2) (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 E1 and group E2 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 E1 and group E2 than in group C (P< 0.05). The NRS pain scores at 2, 4 and 6 h after surgery in group E1 and at 2, 4, 6, 12 and 24 h after surgery in group E2 were lower than in group C (P< 0.05). The NRS pain scores at 6, 12 and 24 h after surgery in group E2 were lower than in group E1 (P< 0.05). The incidence of drowsiness was higher in group E1 and group E2 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.Keywords: esketamine, postoperative quality of recovery, radical mastectomy
