Effect of Different Doses of Esketamine on Postoperative Recovery in Patients Undergoing Gynecologic Laparoscopic Surgery, a Randomized, Double-Blind, Single-Center Clinical Study.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-04-11 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S513571

Tingting Li, Liuhu Han, Zhen Wu, Yanfang Chen, Yiqiao Wang

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Abstract

Purpose: This study aimed to explore the effect of preoperative different doses of esketamine on postoperative recovery in patients undergoing gynecologic laparoscopic surgery.

Methods: A total of 99 women scheduled for gynecologic laparoscopic surgery under general anesthesia were enrolled and randomized. Three minutes before surgical incision, patients in the three groups were intravenously administered 0.25 mg/kg esketamine, 0.5 mg/kg esketamine, and an equivalent dose of saline, respectively. The primary outcome was the Quality of Recovery-15 (QoR-15) score assessed on 1 day (pod1), 3 days (pod3), and 7 days postoperatively (pod7). Secondary outcomes encompassed the VAS score, MAP, HR, frequency of rescue analgesia and length of hospital stay.

Results: Compared with group C, QoR-15 score was significantly improved in group E₁ and E₂ on pod1, while the rest VAS score was significantly decreased at 6h postoperatively (F =19.164, P < 0.001; F = 6.059, P = 0.034). On pod1, the VAS scores at rest and movement in group E₂ were significantly lower than those in group C (P = 0.007, P = 0.038). There was a significant decrease in resting VAS scores in the E₂ group compared with group C on pod3 (P = 0.021). Compared with group C, the QoR-15 score in group E₂ increased on pod7 (P = 0.008), but there was no clinical difference. There was no significant difference in MAP and HR among the three groups at each time point (F = 0.758, P = 0.471; F = 0.232, P = 0.794). There was a significant difference in the number of postoperative rescue analgesia among the three groups (P = 0. 023).

Conclusion: Preoperative single small dose of esketamine can improve the quality of recovery 24h after gynecologic laparoscopic surgery patients, decrease the number of rescue analgesia, and may contribute to the rapid recovery of patients. And 0.5 mg/kg esketamine seems to be better.

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不同剂量艾氯胺酮对妇科腹腔镜手术患者术后恢复的影响：一项随机、双盲、单中心临床研究

目的：探讨术前不同剂量艾氯胺酮对妇科腹腔镜手术患者术后恢复的影响。方法：随机选取99例全麻妇科腹腔镜手术患者。手术切口前3分钟，三组患者分别静脉给予0.25 mg/kg艾氯胺酮、0.5 mg/kg艾氯胺酮和等量生理盐水。主要终点是术后1天（pod1）、3天（pod3）和7天（pod7）的恢复质量-15 （QoR-15）评分。次要结局包括VAS评分、MAP、HR、抢救镇痛次数和住院时间。结果：与C组比较，E1组和E2组pod1 QoR-15评分显著提高，术后6h其余VAS评分显著降低(F =19.164, P < 0.001；F = 6.059, p = 0.034)。E2组休息和运动时VAS评分均显著低于C组（P = 0.007, P = 0.038）。E2组的静息VAS评分在pod3上较C组有显著降低（P = 0.021）。E2组pod7 QoR-15评分较C组升高（P = 0.008），但临床差异无统计学意义。三组患者各时间点MAP、HR比较，差异均无统计学意义(F = 0.758, P = 0.471；F = 0.232, p = 0.794)。三组患者术后抢救镇痛次数比较，差异有统计学意义（P = 0.05）。023)。结论：术前单次小剂量艾氯胺酮可提高妇科腹腔镜手术患者术后24h的恢复质量，减少抢救镇痛次数，有助于患者的快速恢复。而每公斤0.5毫克的艾氯胺酮似乎效果更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.