Perioperative sub-anesthetic esketamine reduces postoperative depression and anxiety and improves sleep quality in acoustic neuroma patients.
In a randomized clinical trial of 77 patients undergoing acoustic neuroma surgery, esketamine significantly reduced the incidence of depression on postoperative day 1 (7.7% vs 31.6%, RR 0.24, 95% CI 0.08-0.80, p=0.008) and day 3 (0.0% vs 15.8%, p=0.031) compared to placebo. Anxiety and sleep disturbances were also significantly reduced, but no significant effects on immune function or pain were observed.
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Perioperative sub-anesthetic esketamine reduces postoperative depression and anxiety and improves sleep quality in acoustic neuroma patients. The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Perioperative sub-anesthetic esketamine reduces postoperative depression and anxiety and improves sleep quality in acoustic neuroma patients.
This conclusion is most relevant to: Patients undergoing acoustic neuroma (AN) surgery (n=77 completers; 39 esketamine, 38 placebo)..
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Effects of sub-anesthetic doses of esketamine on immune function and postoperative negative emotions in acoustic neuroma patients: a randomized clinical trial. (Annals of medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Esketamine blocks NMDA receptors
- ▸Modulates glutamatergic signaling
- ▸Enhances synaptic plasticity and neurotrophic factors
- ▸Result: Reduced postoperative depression and anxiety
Who Might Benefit
Evidence fit by population:
- ▸Patients undergoing acoustic neuroma (AN) surgery (n=77 completers; 39 esketamine, 38 placebo).
Recommended Dose
0.2 mg·kg⁻¹·h⁻¹ intraoperative infusion + 1 mg·kg⁻¹ in PCIA.
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single-center study with relatively small sample size
- ▸Short follow-up limited to early postoperative period (POD1 and POD3)
Frequently Asked Questions
What is the primary benefit of esketamine in acoustic neuroma surgery?▼
Esketamine significantly reduces early postoperative depression and anxiety and improves sleep quality, but does not affect immune function or pain relief.
What dose of esketamine was used in this trial?▼
Patients received a continuous intravenous infusion of 0.2 mg·kg⁻¹·h⁻¹ during anesthesia, followed by 1 mg·kg⁻¹ in patient-controlled intravenous analgesia.
How was depression measured in this study?▼
Depression was measured using the Hospital Anxiety and Depression Scale-Depression subscale (HADS-D), with a score > 7 indicating depression.
Did esketamine improve immune function after surgery?▼
No, the study found no significant differences in immune function between the esketamine and placebo groups.
References
- 1.Chen Z, Wang Y, Cong P, Wang L, Sun P, Li Z, Zhang H, Li G, Jiao F, Zhao J, Li L, Jin Y, Wu Q, Tian L, Jin Y. “Effects of sub-anesthetic doses of esketamine on immune function and postoperative negative emotions in acoustic neuroma patients: a randomized clinical trial..” Annals of medicine, 2026. PMID: 42396903 DOI: 10.1080/07853890.2026.2692804