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Perioperative esketamine improves postoperative sleep quality in patients undergoing laparoscopic cholecystectomy

Esketamine significantly improved postoperative sleep quality compared to control regimens, with a mean difference of -5.78 (95% CI [-6.80 to -4.76]) on a sleep quality scale. This finding was based on a meta-analysis of six randomized controlled trials involving 569 patients.

Last updated: Jul 17, 2026•0 RCTs•1 Meta-analyses•📖 Read as article →

Evidence Score

Evidence Score49/100
Human RCT☆☆☆☆☆
Meta-analysis★★★☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Efficacy and Safety of Esketamine in Patients Undergoing Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

observational

Aldousari AH, Alkandari H, Alruwaished S, Almutairi YMFH, Alkandari A, Alnajdi S, Alsharah M, Termos S · Journal of clinical medicine (2026)

Participants: N/A
Duration: N/A (perioperative period, not specified)
Intervention: Perioperative esketamine (dose not specified in abstract) compared to control regimens (e.g., placebo or standard care)
Outcome: Postoperative sleep quality (measured via a sleep quality scale), wake-up time, postoperative nausea and vomiting (PONV), respiratory depression, pain scores, hemodynamic parameters
Effect Size: MD = -5.78 (95% CI [-6.80 to -4.76]) for sleep quality
Population: Adults undergoing laparoscopic cholecystectomy

Result:

PubMed: 42452364DOI: 10.3390/jcm15134902

Mechanism Graph

Esketamine blocks NMDA receptors in the central nervous system
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This reduces excitatory neurotransmission and pain signaling
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Improved pain control and reduced opioid use may enhance sleep quality
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Result: Improved postoperative sleep quality

Limitations

  • ⚠Only six RCTs with 569 patients were included, limiting generalizability
  • ⚠Pain scores at rest and during movement were not statistically significant, suggesting limited analgesic efficacy

Frequently Asked Questions

What is esketamine?▼

Esketamine is an NMDA receptor antagonist used as an anesthetic and analgesic adjunct, often administered perioperatively to reduce pain and improve recovery.

How does esketamine improve sleep quality after surgery?▼

Esketamine may improve sleep quality by reducing pain and opioid-related side effects, though the exact mechanism is not fully understood. The study found a significant improvement in sleep quality scores.

Is esketamine safe for laparoscopic cholecystectomy?▼

The study reported reduced rates of postoperative nausea and vomiting and respiratory depression with esketamine, suggesting a favorable safety profile, but larger trials are needed.

Does esketamine reduce pain after laparoscopic cholecystectomy?▼

The meta-analysis found lower pain scores with esketamine, but these were not statistically significant, indicating limited evidence for pain reduction.

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References

  1. 1.Aldousari AH, Alkandari H, Alruwaished S, Almutairi YMFH, Alkandari A, Alnajdi S, Alsharah M, Termos S. "Efficacy and Safety of Esketamine in Patients Undergoing Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.." Journal of clinical medicine, 2026. PMID: 42452364 DOI: 10.3390/jcm15134902
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.