Effect of Esketamine on Cognitive Recovery After Propofol Sedation for Outpatient Colonoscopy: A Randomized Clinical Trial

Drug Design Development and Therapy, Год журнала: 2025, Номер Volume 19, С. 425 - 437

Опубликована: Янв. 1, 2025

While esketamine shows promise as an adjunct in procedural sedation, its impact on postoperative cognitive recovery remains incompletely characterized. This study investigated the effects of multiple dimensions recovery, particularly cognition, patients undergoing colonoscopy with propofol-based sedation. We conducted this randomized, double-blinded, placebo-controlled trial from January 6, 2023, to May 20, 2024, at two hospitals China. Patients were randomized a 1:1 ratio receive either 0.2 mg/kg (n = 126) or placebo 126), followed by propofol 1 mg/kg. administered additional boluses (0.5 mg/kg) maintain The assessed day 3 primary outcome, measured Postoperative Quality Recovery Scale (PostopQRS). Secondary outcomes included overall other PostopQRS domains, time discharge, and adverse events. Esketamine significantly enhanced compared (95.2% vs 83.3%, relative risk 1.14; 95% confidence interval: 1.05-1.25, P 0.002). Discharge times comparable between groups (odds 0.70; 0.43-1.16, 0.163). group demonstrated higher satisfaction (P 0.003) reduced incidences hypotension (14.3% 36.5%, < 0.001), bradycardia (5.6% 15.1%, 0.013), hypoxemia (2.4% 8.7%, 0.028), injection site pain (21.4% 48.4%, 0.001). Adding for sedation improved patient satisfaction, cardiopulmonary events without prolonging discharge time. These findings establish low-dose beneficial colonoscopy.

Язык: Английский

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Clinical effects of intravenous patient-controlled analgesia with dexmedetomidine plus inhalation-intravenous combined anesthesia in patients with gastric cancer undergoing laparoscopic radical gastrectomy

Shijie huaren xiaohua zazhi, Год журнала: 2025, Номер 33(1), С. 51 - 59

Опубликована: Янв. 22, 2025

Язык: Английский

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Clinical effects of intravenous patient-controlled analgesia with dexmedetomidine plus inhalation-intravenous combined anesthesia in patients with gastric cancer undergoing laparoscopic radical gastrectomy

Shijie huaren xiaohua zazhi, Год журнала: 2025, Номер 33(1), С. 53 - 61

Опубликована: Янв. 25, 2025

Язык: Английский

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Efficacy and safety of esketamine in preventing perioperative neurocognitive disorders: a meta-analysis of randomized controlled studies

Systematic Reviews, Год журнала: 2025, Номер 14(1)

Опубликована: Март 22, 2025

Perioperative neurocognitive disorders (POND) are common in older adults and associated with adverse outcomes. This meta-analysis aimed to evaluate the efficacy safety of esketamine for prophylaxis POND. Electronic databases were comprehensively searched from inception April 1, 2024, identify randomized controlled trials (RCTs) exploring impact perioperative on POND adult patients. The primary outcomes incidence level postoperative cognitive function. secondary included recovery characteristics (i.e., respiratory depression, extubation time, agitation, hallucinations, nightmares) inflammatory markers. Subgroup meta-regression analyses conducted investigate heterogeneity effect dosage. A total 24 RCTs (n = 2,130 patients), all China relatively short follow-up periods (≤ 3 months), included. Esketamine was found significantly reduce risk (risk ratio:0.53, 95%confidence interval [CI]: 0.43–0.67) improved function day 1 (standardized mean difference [SMD]:1.22, 95%CI:0.85–1.59) (SMD:0.94, 95%CI: 0.46–1.43) compared controls, without impacting characteristics. Furthermore, lower pain scores, reduced nausea/vomiting, decreased levels markers (IL-6, TNF-α, S100β). revealed that age, quality studies, type administration, dosage did not have a significant evidence showed moderate certainty risk, low POD several complications (agitation, PONV, issues, biomarkers (TNF-α, s100β), very cognition, pain, IL-6 levels. is potentially effective reducing improving patients, regardless age Nevertheless, (e.g., 3). Given studies periods, further high-quality diverse populations longer warranted validate these findings.

Язык: Английский

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Effect of Different Doses of Esketamine on Postoperative Recovery in Patients Undergoing Gynecologic Laparoscopic Surgery, a Randomized, Double-Blind, Single-Center Clinical Study

Drug Design Development and Therapy, Год журнала: 2025, Номер Volume 19, С. 2833 - 2843

Опубликована: Апрель 1, 2025

This study aimed to explore the effect of preoperative different doses esketamine on postoperative recovery in patients undergoing gynecologic laparoscopic surgery. A total 99 women scheduled for surgery under general anesthesia were enrolled and randomized. Three minutes before surgical incision, three groups intravenously administered 0.25 mg/kg esketamine, 0.5 an equivalent dose saline, respectively. The primary outcome was Quality Recovery-15 (QoR-15) score assessed 1 day (pod1), 3 days (pod3), 7 postoperatively (pod7). Secondary outcomes encompassed VAS score, MAP, HR, frequency rescue analgesia length hospital stay. Compared with group C, QoR-15 significantly improved E1 E2 pod1, while rest decreased at 6h (F =19.164, P < 0.001; F = 6.059, 0.034). On scores movement lower than those C (P 0.007, 0.038). There a significant decrease resting compared pod3 0.021). increased pod7 0.008), but there no clinical difference. difference MAP HR among each time point 0.758, 0.471; 0.232, 0.794). number 0. 023). Preoperative single small can improve quality 24h after patients, analgesia, may contribute rapid patients. And seems be better.

Язык: Английский

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The effect of esketamine combined with sufentanil based patient-controlled intravenous analgesia for postoperative pain in patients undergoing third molar surgery and maxillofacial trauma: a randomized clinical trial

BMC Oral Health, Год журнала: 2024, Номер 24(1)

Опубликована: Дек. 2, 2024

This study aims to investigate the effects of combining esketamine with sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) in patients undergoing elective impacted tooth surgery or open reduction and internal fixation. In this single-center, prospective, double-blinded, randomized, parallel-controlled trial, 91 were randomly divided into two groups. The experimental group (group ES, n = 46) received a combination 1.5 µg/kg 1.0 mg/kg, while control S, 45) 2 alone PCIA after surgery. Primary outcome was assessed using Visual Analogue Scale (VAS) at rest during mouth opening 6 h, 12 24 48 h post-surgery. Secondary outcomes included Ramsay Sedation (RSS) scores, Quality Recovery-15 (QoR-15) patient satisfaction analgesia, occurrence adverse events within frequency button presses number requiring rescue also recorded. resting VAS scores mouth-opening post-surgery significantly lower Group ES than S (P < 0.05). Additionally, RSS higher 0.032) 0.021) ES. use decreased QoR-15 increased 0.001 P 0.001, respectively). incidences dizziness nausea/vomiting reduced 0.045 0.036, respectively) but one event nightmare observed. There no significant difference between combined third molar maxillofacial trauma can alleviate short-term pain, improve quality recovery. Esketamine is worth promoting clinical application oral retrospectively registered chictr.org.cn identifier: ChiCTR2400086662 on 08/07/2024.

Язык: Английский

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Efficacy and safety of esketamine combined with propofol for conscious sedation in painless colonoscopy: a prospective, randomized, double-blind controlled clinical trial

BMC Anesthesiology, Год журнала: 2024, Номер 24(1)

Опубликована: Окт. 30, 2024

Язык: Английский

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