Effect of Esketamine-Based Opioid-Sparing Anesthesia Protocol on the Quality of Early Recovery After Urological Surgery: A Randomized Clinical Trial.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S511112

Yu Qi, Weihua Li, Ying Ren, Jia Sun, Yangzi Zhu, Long Wang, Meiyan Zhou, Liwei Wang

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引用次数: 0

Abstract

Purpose: The quality of postoperative recovery under enhanced recovery after surgery protocols has always been the focus of anesthesiologists. It has been proven that esketamine application during the perioperative period can reduce the use of opioid drugs and improve the quality of postoperative recovery. The present study explored the effect of the esketamine-based opioid-sparing anesthesia protocol on the quality of postoperative recovery in patients undergoing elective urological surgery.

Patients and methods: A randomized, double-blind, controlled clinical trial was adopted. Patients aged 18-65 years, with American Society of Anesthesiologists physical status grades I-III, scheduled for elective laparoscopic partial nephrectomy or unilateral nephrectomy in urological surgery, were randomly divided into the OSA group and the control group. The OSA group received 0.25 mg/kg of esketamine for anesthesia induction during the operation, and maintenance was carried out at a rate of 0.125 mg·kg⁻¹·h⁻¹. The primary outcome measure was the Quality of Recovery Scale-15 score 24 hours after the operation.

Results: The total Quality of Recovery Scale-15 score was significantly higher in the OSA than in control groups 24 hours after the operation (114 [108, 116] vs 106 [102, 109], p < 0.001). The anesthesia recovery level was better in the OSA than in control groups in the post-anesthesia care unit, demonstrated by shorter eye-opening time (19 [17 20] vs 22 [18, 22], p = 0.031) and extubation time (20 [20, 23] vs 25 [20, 25], p = 0.004). Additionally, the incidence of nausea and vomiting within 0-48 hours after surgery was lower in the OSA than in control groups.

Conclusion: The esketamine-based opioid-sparing anesthesia protocol can improve the quality of early postoperative recovery and the level of anesthesia recovery, and accelerate rehabilitation in patients undergoing elective urological surgery.

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.