Continuous intraoperative esketamine infusion reduces the incidence of postoperative sleep disorders and improves sleep quality in parturients undergoing cesarean section under general anesthesia.
In a randomized, double-blind, placebo-controlled trial, 140 parturients undergoing elective cesarean delivery under general anesthesia received either continuous esketamine (0.3 mg/kg/h) or saline after delivery. At 3 and 7 days post-surgery, the esketamine group had significantly lower PSQI scores, lower sleep NRS scores, and lower incidence of PSD and postpartum depression compared to controls. The intervention also reduced pain scores and rescue analgesia use within 72 hours.
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Continuous intraoperative esketamine infusion reduces the incidence of postoperative sleep disorders and improves sleep quality in parturients undergoing cesarean section under general anesthesia. The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Continuous intraoperative esketamine infusion reduces the incidence of postoperative sleep disorders and improves sleep quality in parturients undergoing cesarean section under general anesthesia.
This conclusion is most relevant to: Parturients undergoing elective cesarean section under general anesthesia.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸The effect of esketamine on sleep disorders in parturients undergoing cesarean section under general anesthesia: a single-center, randomized, double-blind, placebo-controlled prospective study. (Frontiers in medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Esketamine provides analgesic effects reducing postoperative pain
- ▸Reduced pain leads to better sleep continuity and quality
- ▸Esketamine may have antidepressant effects reducing postpartum depression
- ▸Improved mood and pain contribute to lower PSD incidence
Who Might Benefit
Evidence fit by population:
- ▸Parturients undergoing elective cesarean section under general anesthesia
Recommended Dose
0.3 mg/kg/h continuous infusion
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single-center study may limit generalizability
- ▸No long-term follow-up beyond 7 days post-surgery
- ▸Potential unblinding due to psychoactive effects of esketamine
- ▸Specific mechanism for sleep improvement not directly measured
Frequently Asked Questions
What is the recommended dose of esketamine for preventing sleep disorders after cesarean section?▼
The study used a continuous infusion of 0.3 mg/kg/h after delivery, which significantly reduced postoperative sleep disorder incidence.
How does esketamine improve sleep quality in postpartum women?▼
Esketamine likely improves sleep by reducing postoperative pain and depressive symptoms, which are known to interfere with sleep.
Are there any risks associated with esketamine use in cesarean section?▼
The abstract mentions evaluation of adverse reactions and maternal-neonatal complications, but specific risks are not detailed; however, esketamine is generally used under anesthesia supervision.
What are the risk factors for postoperative sleep disorder in cesarean patients?▼
The study identified a 24-hour postpartum pain NRS score (OR=1.485) and antepartum sleep disorder (OR=4.757) as significant risk factors.
References
- 1.Chen H, An L, Zhang P, Xiao M, Wang Q. “The effect of esketamine on sleep disorders in parturients undergoing cesarean section under general anesthesia: a single-center, randomized, double-blind, placebo-controlled prospective study..” Frontiers in medicine, 2026. PMID: 42602089 DOI: 10.3389/fmed.2026.1837631