The effects of S-ketamine on postoperative sleep quality in patients undergoing thoracoscopic surgery: a randomized study

Abstract

Background: Postoperative sleep disturbance (PSD) is a common and uncomfortable experience for patients, which induces various negative clinical outcomes and increases the perioperative mortality. Thus, it is necessary to seek efficient methods to improve PSD. This study was designed to explore whether perioperative intravenous S-ketamine could improve sleep quality. Methods: Patients undergoing elective thoracoscopic surgery were recruited and assigned into two groups randomly. 0.5 mg/kg of S-ketamine was given to the individuals in the experimental group during the period of anesthesia induction followed by 0.1mg/kg/h intravenous infusion until 15 minutes before the completion of the procedure, while normal saline in the same protocol was performed in the control group. The primary outcomes included the salivary melatonin (MT) concentration on the first day after surgery, and the Richard Campbell Sleep Questionnaire (RSCQ) scores on the first three days postoperatively. The secondary outcomes were the rest and movement Visual Analogue Scale (VAS) score at 6, 12, 24, and 48 hours postoperatively, the level of serum IL-6 and IL-10 on the first day postoperatively, and the incidence of postoperative negative complications. Results: In the experimental group, the RSCQ scores on the first three days postoperatively and the level of MT on the first day after the procedure were significantly higher, and the rest and movement pain intensity at postoperative 6, 12 and 24 hours were statistically lower when compared with the control group, while the results at 48 hours postoperatively were comparable in both groups. In addition, the higher level of IL-6 and lower level of IL-10 postoperatively were noticed in the experimental group. In both groups, the incidence of negative outcomes was similar. Conclusion: S-ketaminecan effectively improve postoperative sleep quality, and reduce pain intensity and inflammation in patients undergoing thoracoscopic surgery.