BMC anesthesiology
May 24, 2024
Xinru Lin, Xiaoxue Feng, Linxiao Sun et al.
21 citations
Perioperative esketamine reduces postoperative fatigue syndrome (POFS) after laparoscopic radical gastrectomy for gastric cancer. In a double-blind randomized trial, 133 patients received either standard anesthesia alone or with esketamine. The esketamine group had significantly lower Christensen fatigue scores on postoperative day 3 (estimated difference -0.70; 95% CI -1.37 to -0.03) and less fatigue on days 1 and 3. Patients who had total gastrectomy showed greater fatigue reduction with esketamine than those who had distal gastrectomy. Esketamine also reduced postoperative pain and improved sleep, with no increase in adverse events.
BMC anesthesiology
December 5, 2024
Xing Lin, Xin Liu, Huoming Huang et al.
15 citations
A meta-analysis of 13 randomized controlled trials involving 1068 adult surgical patients found that intravenous esketamine given during general anesthesia reduced the risk of postoperative delirium by 54% and postoperative cognitive dysfunction by 50%, with high to moderate certainty of evidence. Esketamine also improved cognitive status at 4, 24, and 48 hours after surgery, decreased intraoperative remifentanil use, and lowered the risk of postoperative nausea and vomiting by 36%. These results suggest esketamine as a potentially beneficial adjunct to general anesthesia for protecting against perioperative neurocognitive disorders.
BMC anesthesiology
August 19, 2024
Qinyu Jiang, Yu Qi, Meiyan Zhou et al.
11 citations
Small doses of esketamine given intravenously to patients with postpartum depression increased serum concentrations of the neurotransmitters 5-hydroxytryptamine (5-HT), dopamine (DA), and brain-derived neurotrophic factor (BDNF) by the third day after administration, compared to a saline placebo. Edinburgh Postnatal Depression Scale (EPDS) scores were significantly lower in the esketamine group on day 3 (12.98 vs. 16.73), but this difference was no longer present on day 30. Adverse event rates within two hours were similar between groups. The findings suggest esketamine can transiently improve postpartum depressive symptoms and alter certain neurotransmitter levels.
BMC anesthesiology
July 1, 2025
Yanan Wu, Yaning Yang, Xiaomei Wang et al.
9 citations
Intraoperative infusion of low-dose esketamine (0.5 mg/kg/h) significantly reduced postoperative sleep disturbance (PSD) after laparoscopic cholecystectomy. In a randomized trial, PSD incidence was lower in the esketamine group than the placebo group on postoperative day 1 (58.1% vs. 81.4%), day 2 (11.6% vs. 44.2%), and day 3 (2.3% vs. 18.6%). The esketamine group also had lower postoperative pain scores and less intraoperative remifentanil use, with no difference in adverse reactions. Longer operation duration, higher ASA grade, and drain insertion were independent risk factors for PSD.
BMC anesthesiology
May 31, 2024
Xin Luo, Wen-Wen Hao, Xue Zhang et al.
7 citations
Adding esketamine to propofol reduces the amount of propofol needed for successful ureteroscope insertion in elderly male patients compared with adding sufentanil. In a randomized trial of 49 elderly men undergoing rigid ureteroscopy, the median effective dose (ED50) of propofol was 1.356 mg/kg with esketamine versus 1.442 mg/kg with sufentanil, a statistically significant decrease. Induction time was also shorter with esketamine, and hemodynamic stability was better. Rates of adverse events such as hypoxemia and body movement did not differ between groups. The combination may improve safety by lowering propofol requirements in this older population.
BMC anesthesiology
July 5, 2025
Dujuan Qiao, Wei Liu, Huanjia Xue et al.
5 citations
In mechanically ventilated patients with ARDS, esketamine combined with midazolam improved respiratory system compliance and oxygenation compared with remifentanil combined with midazolam. At 72 hours after medication, static compliance was higher in the esketamine group (49.8 ± 13.8) than in the control group (42.4 ± 11.9), while plateau pressure and peak airway pressure were lower. Both groups received equivalent sedation and analgesia. The findings suggest esketamine may offer respiratory advantages in this population.
BMC anesthesiology
May 3, 2024
David P Obert, David Killing, Tom Happe et al.
5 citations
Mice anesthetized with sevoflurane, propofol, ketamine, or dexmedetomidine show substance-specific changes in brain wave patterns recorded from electrodes on the cortex. Sevoflurane and propofol decreased theta/alpha band power and increased beta/gamma power around loss of righting reflex. Dexmedetomidine shifted activity toward lower frequencies, increasing delta waves. Ketamine produced stronger high-frequency activity. These patterns partly matched those seen in humans but differed notably in low frequencies. The findings highlight both the usefulness and limitations of mouse models for studying anesthesia-induced unconsciousness.
BMC anesthesiology
October 23, 2024
Longyuan Zhou, Lei Lv, Ruilan Wu et al.
4 citations
Adding esketamine to lidocaine during local anaesthesia for percutaneous kyphoplasty in elderly patients reduces pain and improves safety and comfort. In a trial of 66 patients aged 60–80, those receiving lidocaine plus esketamine reported lower pain scores during needle insertion, balloon dilation, cement injection, and after surgery compared with those receiving lidocaine alone. Blood pressure and heart rate were more stable, sedation scores were lower, and patient satisfaction reached 100% in the combination group versus 48% in the lidocaine-only group. No complications occurred in either group.
BMC anesthesiology
July 29, 2025
Zhaoli Wang, Hongqin Li, Yu Wang et al.
2 citations
A 0.25 mg/kg dose of esketamine, given during ureteroscopic lithotripsy, reduced the incidence of moderate-to-severe catheter-related bladder discomfort immediately after surgery from 33.9% with placebo to 9.1%. The higher dose also lowered discomfort at 1 and 6 hours postoperatively and reduced the need for tramadol rescue pain medication. A lower dose of 0.15 mg/kg did not produce significant benefits. No increase in adverse effects was observed with the 0.25 mg/kg dose, suggesting it is a safe and effective option for preventing this distressing complication.
BMC anesthesiology
July 1, 2025
Jun-Wei Qi, Chuang Li, Xin-Yuan Qiu et al.
2 citations
Preoperative use of a combination of intranasal dexmedetomidine and esketamine reduces postoperative pain in children undergoing tonsillectomy and adenoidectomy. Among 173 children, the combination group had a lower area under the curve for pain scores at rest within 24 hours (9.50) compared with dexmedetomidine alone (19.25) or saline (37.25). The combination also lowered the incidence of emergence delirium to 12.3% versus 44.8% in the control group. Heart rates were higher in the combination and control groups than in the dexmedetomidine-only group. No serious adverse events occurred.
BMC anesthesiology
July 1, 2025
Yihuan Luo, Hua Fang
1 citation
In patients undergoing thyroid surgery, adding esketamine to the anesthetic regimen improves recovery quality, reduces pain and coughing, and maintains stable blood pressure and heart rate. A dose of 0.25 mg/kg provides the best balance of benefits and faster recovery compared to 0.35 mg/kg. Both doses lowered pain scores and anxiety and depression scores after surgery.
BMC anesthesiology
May 8, 2025
Guang-Qiu Zhu, Yu Wang, Xiao-Xia Wang et al.
1 citation
A low-dose combination of esketamine and propofol for general anesthesia induction during category-1 emergency cesarean sections maintained maternal hemodynamic stability without causing neonatal depression. In a case series of 11 patients, the median 1-minute Apgar score was 9 and the 5-minute Apgar score was 10 for all newborns. The mean decision-to-delivery interval was 10.9 minutes. Only one newborn required temporary mask ventilation due to acute fetal distress from placental abruption; no newborns were admitted to the ICU. No episodes of hypotension, intraoperative awareness, reflux aspiration, or adverse psychiatric effects occurred. The strategy appears suitable, but randomized controlled trials are needed to confirm these findings.