Intravenous esketamine 0.3 mg/kg during anesthesia induction improves early postoperative sleep quality in female patients undergoing laparoscopic surgery
In a randomized controlled trial of 98 female patients undergoing laparoscopic surgery, those who received esketamine 0.3 mg/kg during anesthesia induction had significantly lower Pittsburgh Sleep Quality Index (PSQI) scores on postoperative days 1 and 3 compared to controls (P<0.05). The esketamine group also had reduced intraoperative sufentanil consumption, lower VAS pain scores at 6 and 24 hours, and a lower 24-hour rescue analgesia rate, with no significant differences in adverse events or recovery times.
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Intravenous esketamine 0.3 mg/kg during anesthesia induction improves early postoperative sleep quality in female patients undergoing laparoscopic surgery The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Intravenous esketamine 0.3 mg/kg during anesthesia induction improves early postoperative sleep quality in female patients undergoing laparoscopic surgery
This conclusion is most relevant to: Female patients (ASA I-II, aged 25-50) undergoing elective laparoscopic surgery.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Esketamine during anesthesia induction improves early postoperative sleep quality in female patients undergoing laparoscopic surgery: A randomized trial. (Pakistan journal of medical sciences, 2026) — In a randomized controlled trial of 98 female patients undergoing laparoscopic surgery, those who received esketamine 0.3 mg/kg during anesthesia induction had significantly lower Pittsburgh Sleep Quality Index (PSQI) scores on postoperative days 1 and 3 compared to controls (P<0.05). The esketamine group also had reduced intraoperative sufentanil consumption, lower VAS pain scores at 6 and 24 hours, and a lower 24-hour rescue analgesia rate, with no significant differences in adverse events or recovery times.
How It Works
The proposed biological pathway:
- ▸Esketamine blocks NMDA receptors, providing analgesic effects
- ▸Reduced intraoperative opioid consumption (sufentanil) due to esketamine's analgesic action
- ▸Lower postoperative pain scores (VAS) and reduced need for rescue analgesia
- ▸Improved early postoperative sleep quality (lower PSQI scores on POD 1 and 3)
Who Might Benefit
Evidence fit by population:
- ▸Female patients (ASA I-II, aged 25-50) undergoing elective laparoscopic surgery
Recommended Dose
0.3 mg/kg
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single-center study with a relatively small sample size (n=98)
- ▸Only female patients, limiting generalizability to male patients
- ▸Follow-up limited to 7 days postoperatively; long-term sleep effects not assessed
Frequently Asked Questions
What is the recommended dose of esketamine for improving postoperative sleep?▼
The study used a single dose of 0.3 mg/kg administered intravenously during anesthesia induction.
Does esketamine reduce postoperative pain?▼
Yes, the esketamine group had lower VAS pain scores at 6 and 24 hours postoperatively and a lower 24-hour rescue analgesia rate compared to control.
Are there any adverse effects of esketamine in this context?▼
No significant differences in adverse event rates were observed between groups, and no severe adverse events were reported.
How long does the sleep improvement last?▼
The improvement in PSQI scores was significant on postoperative days 1 and 3, but by day 7 there was no significant difference between groups.
References
- 1.Du R, Fei G, Zhang J, Cheng Q. “Esketamine during anesthesia induction improves early postoperative sleep quality in female patients undergoing laparoscopic surgery: A randomized trial..” Pakistan journal of medical sciences, 2026. PMID: 42668869 DOI: 10.12669/pjms.42.8.16352