Supplements

Intraoperative esketamine infusion reduces early postoperative sleep disturbance in patients undergoing shoulder arthroscopy

In a randomized controlled trial of 80 patients with preoperative sleep disturbance undergoing shoulder arthroscopy, intraoperative esketamine infusion (0.3 mg/kg/h) significantly reduced the incidence of sleep disturbance on postoperative day 1 compared to placebo (5.0% vs. 27.5%; risk ratio 0.18, 95% CI 0.04-0.77). The esketamine group also showed longer device-estimated total sleep time on POD1 and lower Athens Insomnia Scale scores on POD1, POD3, and POD7, with improved PSQI scores at POD30.

Last updated: Jul 20, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Intraoperative esketamine infusion and postoperative sleep quality after shoulder arthroscopy: a randomized controlled trial.

observational

Liu C, Lu W, Ni L, Yao S · Frontiers in pharmacology (2026)

Participants: N/A
Duration: 30 days
Intervention: Intraoperative esketamine infusion at 0.3 mg/kg/h
Outcome: Sleep disturbance (Athens Insomnia Scale ≥6), device-estimated total sleep time, subjective sleep parameters (AIS, PSQI), pain scores, psychological outcomes, adverse events
Effect Size: Risk ratio 0.18 (95% CI 0.04-0.77)
Population: Adult patients with preoperative sleep disturbance undergoing shoulder arthroscopy

Result:

PubMed: 42460017DOI: 10.3389/fphar.2026.1864069

Mechanism Graph

Esketamine blocks NMDA receptors, reducing central sensitization
↓
Decreased pain perception during and after surgery
↓
Improved pain control reduces sleep disruption
↓
Result: Lower incidence of postoperative sleep disturbance

Limitations

  • ⚠Single-center design limits generalizability
  • ⚠Small sample size (n=80) may affect precision of estimates
  • ⚠Wearable-derived sleep parameters are exploratory and not validated against polysomnography

Frequently Asked Questions

What is the primary outcome measured in this study?▼

The primary outcome was sleep disturbance, defined as an Athens Insomnia Scale score ≥6 on postoperative day 1.

How much esketamine was given to patients?▼

Patients received an intraoperative infusion of esketamine at a dose of 0.3 mg/kg/h.

Did esketamine improve sleep quality beyond the first postoperative day?▼

Yes, subjective sleep measures favored the esketamine group, with lower Athens Insomnia Scale scores on POD1, POD3, and POD7, and lower PSQI scores at POD30.

What are the main limitations of this trial?▼

The trial was single-center with a small sample size, and the wearable sleep monitoring used exploratory parameters not validated against gold-standard polysomnography.

Products

Affiliate links coming soon. We only recommend products that match the doses and forms used in the cited research.

References

  1. 1.Liu C, Lu W, Ni L, Yao S. "Intraoperative esketamine infusion and postoperative sleep quality after shoulder arthroscopy: a randomized controlled trial.." Frontiers in pharmacology, 2026. PMID: 42460017 DOI: 10.3389/fphar.2026.1864069
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.