Effects of the Different Doses of Esketamine on Postoperative Quality of Recovery in Patients Undergoing Modified Radical Mastectomy: A Randomized, Double-Blind, Controlled Trial

Abstract

Purpose

This study aims to investigate the effects of the different doses of esketamine on postoperative quality of recovery in patients undergoing modified radical mastectomy.

Methods

Ninety-nine female patients were randomly allocated to three groups: the low-dose esketamine group (group E ₁) (0.5 mg/kg loading, 2 µg/kg/h infusion), the high-dose esketamine group (group E ₂) (0.5 mg/kg loading, 4 µg/kg/h infusion), the control group (group C) (received normal saline). The primary outcome was the quality of recovery-15 (QoR-15) scores on postoperative day 1 (POD1) and days 3 (POD3). The secondary outcomes were the sleep quality scores on POD1, bispectral index (BIS) value at 10, 30, and 60 min after operation, numeric rating scale (NRS) pain scores within 24 h after surgery, nausea, vomiting, drowsiness, nightmare, and intraoperative awareness.

Results

The total QoR-15 scores were higher in group E ₁ and group E ₂ than in group C on POD1 and POD3 ( P<0.05). The sleep quality scores on POD1 and BIS value at 10, 30, and 60 min after operation were higher in group E ₁ and group E ₂ than in group C ( P<0.05). The NRS pain scores at 2, 4 and 6 h after surgery in group E ₁ and at 2, 4, 6, 12 and 24 h after surgery in group E ₂ were lower than in group C ( P<0.05). The NRS pain scores at 6, 12 and 24 h after surgery in group E ₂ were lower than in group E ₁ ( P<0.05). The incidence of drowsiness was higher in group E ₁ and group E ₂ than in group C ( P<0.05).

Conclusion

Esketamine infusion improved to some extent the quality of recovery on POD1 and POD3 in patients undergoing modified radical mastectomy, especially 4 µg/kg/h esketamine was better, but the BIS value and incidence of drowsiness were significantly increased.