Esketamine vs. placebo combined with erector spinae plane block vs. intercostal nerve block on quality of recovery following thoracoscopic lung resection: a randomized controlled factorial trial.
International journal of surgery (London, England) January 1, 2025 Jing-Hui Hu, Zhang-Zhen Zhong, Hai-Jing Shi et al. 21 citations
Adding a low dose of the anesthetic esketamine to a multimodal pain regimen improved the quality of recovery for patients after thoracoscopic lung surgery, while two different regional nerve blocks—erector spinae plane block and intercostal nerve block—provided similar benefits. In a randomized trial of 100 adults, those receiving intravenous esketamine (0.3 mg/kg) scored an average of 111.5 on the quality-of-recovery scale at 24 hours, compared with 105.4 for placebo, a difference exceeding the minimal clinically important threshold of 6.0 points. The esketamine group also had higher scores at 48 hours and hospital discharge. No significant interaction occurred between esketamine and the type of nerve block, and the two blocks yielded comparable recovery scores, suggesting they can be used interchangeably.