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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.

Last updated: Aug 31, 2026•1 RCTs•📖 Read as article →

Evidence Score

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

Study Evidence

Study 1. Esketamine during anesthesia induction improves early postoperative sleep quality in female patients undergoing laparoscopic surgery: A randomized trial.

rct

Du R, Fei G, Zhang J, Cheng Q · Pakistan journal of medical sciences (2026)

Participants: 100
Duration: 7 days
Intervention: Esketamine 0.3 mg/kg intravenously during anesthesia induction
Outcome: Postoperative sleep quality (PSQI scores on POD 1, 3, 7), intraoperative sufentanil use, VAS pain scores at 6/24h, rescue analgesia rate, adverse events, emergence time, PACU stay
Effect Size: N/A (P<0.05 for PSQI on POD 1 and 3, but no effect size reported)
Population: Female patients (ASA I-II, aged 25-50) undergoing elective laparoscopic surgery

Result: 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.

PubMed: 42668869DOI: 10.12669/pjms.42.8.16352

Mechanism Graph

Esketamine blocks NMDA receptors, providing analgesic effects
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Reduced intraoperative opioid consumption (sufentanil) due to esketamine's analgesic action
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Lower postoperative pain scores (VAS) and reduced need for rescue analgesia
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Improved early postoperative sleep quality (lower PSQI scores on POD 1 and 3)

Limitations

  • ⚠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.

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References

  1. 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
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.