Intraoperative Esketamine Is Effective at Reducing Acute Postoperative Pain in Bariatric Surgery Patients: a Randomized Control Trial

Yang, Ting; Mudabbar, Muhammad Saqib; Liu, Bin; Xu, Min; Fu, Qiang

doi:10.1007/s11695-023-06676-2

Cited by 4 publications

(10 citation statements)

References 25 publications

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“…As well, our study showed similar results as Xu 's. Yang's research showed that continuous infusion of esketamine after induction with esketamine until 30min before the end of surgery reduced postoperative NRS scores [21] . The short half-life of esketamine and the use of urpinoxamate for pre-incision and postoperative analgesia, as well as nerve block analgesia in our study, may explain our expected results.…”

Section: Discussionsupporting

confidence: 86%

“…This could be either due to the differences in the combination of drugs used, the dosage, or differences in the types of surgeries. Compared with Yang's study [21] , our extubation times were longer, probably because in our experiment, we returned to PACU immediately after the operation, and nurse anesthetists generally did not take the initiative to wake patients. So that extubation time in our study were longer.…”

Section: Discussionmentioning

confidence: 60%

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Single intravenous subanesthetic dose of esketamine failed to relieve postoperative pain in obese patients undergoing bariatric surgery: a randomized controlled clinical trial

Hu,

Zhang,

Yang

et al. 2024

Preprint

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Background:Multimodal analgesia during bariatric surgery is beneficial to accelerate postoperative recovery. Esketamine has been used in anesthesia and analgesia. However, the analgesic effect of single infusion subanesthetic dose of esketamine in obese patients undergoing bariatric surgery is unclear yet. The study aimed to illustrate whether intraoperative intravenous subanesthetic dose of esketamine could relieve pain in bariatric surgery patients. Methods:Patients (n = 51) scheduled for laparoscopic bariatric surgery were randomly divided into two groups: the esketamine group (group E: 0.2 mg/Kg esketamine before surgical incision) or the saline group (group S: equivalent dose saline before surgical incision). The primary outcomes included pain in Post Anesthesia Care Unit (PACU) and on the first postoperative day (POD1), and the intravenous morphine equivalent (IVME) on POD1. The second measures included adverse reactions, postoperative nausea and vomitting (PONV), duration of extubation, incidence of intraoperative hypotension and first time out of bed after surgery. Results:Finally, 40 patients completed the study. PACU and POD1 numerical rating scale (NRS) scores revealed no significant difference, nor did IVME on POD1. Conclusions: Single infusion subanesthetic doses of esketamine does not relieve acute pain or reduce morphine consumption postoperative in patients undergoing bariatric surgery. To realize meaningful postoperative analgesic benefit, increased dosages or prolonged infusions of esketamine might be required. Trial registration: The study was registered at Chinese Clinical Trial Registry https://www.chictr.org.cn/, (Registration date: 7/12/2021; Identifier: ChiCTR2100054038).

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 60%

Single intravenous subanesthetic dose of esketamine failed to relieve postoperative pain in obese patients undergoing bariatric surgery: a randomized controlled clinical trial

Hu,

Zhang,

Yang

et al. 2024

Preprint

Self Cite

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“…This finding is consistent with previous studies, some of which employed higher doses of esketamine (0.25 mg/kg, 0.4 mg/kg). [ 25 , 29 – 31 ]…”

Section: Discussionmentioning

confidence: 99%

“…This is a secondary study that shares the same trial registration number (ChiCTR2100054038) as a previously published study by Yang et al (2023). [ 25 ]…”

Section: Methodsmentioning

confidence: 99%

The effects of esketamine on blood pressure and hypotension incidence during induction of bariatric surgery: A randomized controlled trial

Yang,

Mudabbar,

et al. 2023

Medicine

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Background: The prevalence of obesity is high. Bariatric surgery is an effective treatment for severe obesity; however, the induction phase of anesthesia in these patients poses a risk of hypotension. Esketamine, known for its sympathetic nervous system stimulation, may stabilize blood pressure during induction. This study aimed to investigate the effects of esketamine on blood pressure in bariatric surgery patients. Methods: This randomized controlled trial included 145 patients undergoing bariatric surgery. Patients were randomly assigned to receive esketamine or a control intervention during induction. Blood pressure and other vital signs were measured and compared between the 2 groups using statistical analyses. Results: Administration of esketamine increased blood pressure before intubation (T2). The incidence of hypotension was lower in the esketamine group at multiple time points during induction. Postoperatively, the esketamine group exhibited lower pain scores at 24 hours and a reduced need for rescue analgesics. Conclusion: A single dose of 0.2 mg/kg esketamine during the induction phase of bariatric surgery can improve blood pressure stability and decrease the incidence of hypotension. Furthermore, it is associated with reduced postoperative pain. Future studies could explore the effects of higher esketamine doses and validate these findings in a larger and more diverse patient population.

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“… 4 A number of studies have used esketamine for postoperative analgesia and have shown that esketamine achieves the desired analgesic effect: in a randomised, double-blind, controlled study of 68 patients undergoing bariatric surgery and receiving either intravenous esketamine or placebo, intraoperative use of low-dose esketamine significantly reduced the patients’ acute postoperative pain. 5 In a study of the efficacy of low-dose esketamine in combination with sufentanil for postoperative analgesia after caesarean section in women with gestational diabetes mellitus, the addition of low-dose esketamine significantly reduced postoperative sufentanil dosage and was effective in lowering postoperative pain scores in women with gestational diabetes mellitus, as compared with the control group. 6 However, in a prospective randomised controlled study by Touil et al on intraoperative ketamine for the prevention of severe rebound pain after cessation of peripheral nerve block, ketamine did not reduce the incidence or intensity of rebound pain after peripheral nerve block.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intravenous Administration of Esketamine in Preventing and Treating Rebound Pain After Thoracic Paravertebral Nerve Block: A Prospective Randomized, Double-Blind, Placebo-Controlled Trial

Zeng,

Zhang,

Jiang

et al. 2024

DDDT

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Purpose Investigating the efficacy of intraoperative fractionated intravenous esketamine in the prevention of rebound pain after cessation of thoracic paravertebral nerve blockade. Methods One hundred and twenty patients who underwent elective thoracoscopic lobectomy were selected for the study and were randomly divided into two groups, the esketamine group was given 0.5 mg/kg and 0.3 mg/kg of esketamine at the induction of anaesthesia and 30 minutes before the end of the operation, respectively, and the control group was given an equal amount of saline. The incidence of rebound pain (RP) 7 days after surgery and postoperative recovery were compared between the two groups. Results The NRS pain scores at 24 and 48 hours postoperatively in the esketamine group were significantly lower than those in the control group (P < 0.05). The incidence of postoperative rebound pain was significantly lower in the esketamine group than in the control group (P < 0.05). The consumption of sufentanil was less in the esketamine group in the postoperative 48 hours (P < 0.05). Postoperative recovery was compared between the two groups and the difference was not statistically significant. Conclusion Intravenous esketamine reduces postoperative pain scores, decreases the incidence of rebound pain after cessation of thoracic paravertebral block, and reduces opioid consumption.

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Intraoperative Esketamine Is Effective at Reducing Acute Postoperative Pain in Bariatric Surgery Patients: a Randomized Control Trial

Cited by 4 publications

References 25 publications

Single intravenous subanesthetic dose of esketamine failed to relieve postoperative pain in obese patients undergoing bariatric surgery: a randomized controlled clinical trial

Single intravenous subanesthetic dose of esketamine failed to relieve postoperative pain in obese patients undergoing bariatric surgery: a randomized controlled clinical trial

The effects of esketamine on blood pressure and hypotension incidence during induction of bariatric surgery: A randomized controlled trial

Efficacy of Intravenous Administration of Esketamine in Preventing and Treating Rebound Pain After Thoracic Paravertebral Nerve Block: A Prospective Randomized, Double-Blind, Placebo-Controlled Trial

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