Na Yang, Lihua Peng, Ruixing Kuang, Rui Xu, Ling Zhou, Yinglong Wang
{"title":"围手术期静脉注射氯胺酮对非心脏手术患者术后睡眠障碍的影响：一项系统回顾和荟萃分析。","authors":"Na Yang, Lihua Peng, Ruixing Kuang, Rui Xu, Ling Zhou, Yinglong Wang","doi":"10.4103/ija.ija_75_25","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Postoperative sleep disturbance (PSD) is a common condition that may lead to pain, cognitive impairment, depression, and delayed recovery. This review evaluates the efficacy of perioperative intravenous ketamine in alleviating PSD and offers evidence-based recommendations for clinical practice.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Embase, Cochrane Library, Wanfang Data, VIP Information Resource System, China National Knowledge Infrastructure and China Biology Medicine disc (SinoMed) up to 6<sup>th</sup> November 2024. This article included a meta-analysis of randomised controlled trials (RCTs) along with a Grading of Recommendations Assessment, Development and Evaluation analysis.</p><p><strong>Results: </strong>A total of 2355 patients from 21 RCTs were analysed. The pooled results indicated that ketamine improved sleep quality compared to placebo on the first postoperative day, as evidenced by a reduction in Pittsburgh Sleep Quality Index scores [mean difference (MD): -2.69; 95% confidence interval (CI): -3.95, -1.42; <i>P</i> < 0.0001, <i>I</i> <sup>2</sup> = 96%]. Ketamine also improved sleep quality on the second postoperative day (MD: -2.45; 95% CI: -3.99, -0.91; <i>P</i> = 0.002, <i>I</i> <sup>2</sup> = 96%) and during the first three postoperative days (MD: -2.90; 95% CI: -4.79, -1.00; <i>P</i> = 0.003, <i>I</i> <sup>2</sup> = 97%). In addition, ketamine reduced Visual Analogue Scale scores for pain (MD: -0.38; 95% CI: -0.55, -0.21; <i>P</i> < 0.00001, <i>I</i> <sup>2</sup> = 84%). These results suggest that ketamine reduces PSDs and pain without significantly increasing adverse reactions. However, given the high heterogeneity and limited quality of evidence in this review, the results should be interpreted with caution.</p><p><strong>Conclusion: </strong>This meta-analysis indicates that administering ketamine during the perioperative period can enhance postoperative sleep quality. However, the optimal dose, timing and method of administration remain undetermined, emphasising the need for further research to establish standardised guidelines.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"434-449"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068437/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of perioperative intravenous ketamine on postoperative sleep disturbance in patients undergoing non-cardiac surgery: A systematic review and meta-analysis.\",\"authors\":\"Na Yang, Lihua Peng, Ruixing Kuang, Rui Xu, Ling Zhou, Yinglong Wang\",\"doi\":\"10.4103/ija.ija_75_25\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Postoperative sleep disturbance (PSD) is a common condition that may lead to pain, cognitive impairment, depression, and delayed recovery. This review evaluates the efficacy of perioperative intravenous ketamine in alleviating PSD and offers evidence-based recommendations for clinical practice.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Embase, Cochrane Library, Wanfang Data, VIP Information Resource System, China National Knowledge Infrastructure and China Biology Medicine disc (SinoMed) up to 6<sup>th</sup> November 2024. This article included a meta-analysis of randomised controlled trials (RCTs) along with a Grading of Recommendations Assessment, Development and Evaluation analysis.</p><p><strong>Results: </strong>A total of 2355 patients from 21 RCTs were analysed. The pooled results indicated that ketamine improved sleep quality compared to placebo on the first postoperative day, as evidenced by a reduction in Pittsburgh Sleep Quality Index scores [mean difference (MD): -2.69; 95% confidence interval (CI): -3.95, -1.42; <i>P</i> < 0.0001, <i>I</i> <sup>2</sup> = 96%]. Ketamine also improved sleep quality on the second postoperative day (MD: -2.45; 95% CI: -3.99, -0.91; <i>P</i> = 0.002, <i>I</i> <sup>2</sup> = 96%) and during the first three postoperative days (MD: -2.90; 95% CI: -4.79, -1.00; <i>P</i> = 0.003, <i>I</i> <sup>2</sup> = 97%). In addition, ketamine reduced Visual Analogue Scale scores for pain (MD: -0.38; 95% CI: -0.55, -0.21; <i>P</i> < 0.00001, <i>I</i> <sup>2</sup> = 84%). These results suggest that ketamine reduces PSDs and pain without significantly increasing adverse reactions. However, given the high heterogeneity and limited quality of evidence in this review, the results should be interpreted with caution.</p><p><strong>Conclusion: </strong>This meta-analysis indicates that administering ketamine during the perioperative period can enhance postoperative sleep quality. However, the optimal dose, timing and method of administration remain undetermined, emphasising the need for further research to establish standardised guidelines.</p>\",\"PeriodicalId\":13339,\"journal\":{\"name\":\"Indian Journal of Anaesthesia\",\"volume\":\"69 5\",\"pages\":\"434-449\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068437/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Anaesthesia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/ija.ija_75_25\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Anaesthesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ija.ija_75_25","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/16 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Effect of perioperative intravenous ketamine on postoperative sleep disturbance in patients undergoing non-cardiac surgery: A systematic review and meta-analysis.
Background and aims: Postoperative sleep disturbance (PSD) is a common condition that may lead to pain, cognitive impairment, depression, and delayed recovery. This review evaluates the efficacy of perioperative intravenous ketamine in alleviating PSD and offers evidence-based recommendations for clinical practice.
Methods: A systematic search was performed in PubMed, Embase, Cochrane Library, Wanfang Data, VIP Information Resource System, China National Knowledge Infrastructure and China Biology Medicine disc (SinoMed) up to 6th November 2024. This article included a meta-analysis of randomised controlled trials (RCTs) along with a Grading of Recommendations Assessment, Development and Evaluation analysis.
Results: A total of 2355 patients from 21 RCTs were analysed. The pooled results indicated that ketamine improved sleep quality compared to placebo on the first postoperative day, as evidenced by a reduction in Pittsburgh Sleep Quality Index scores [mean difference (MD): -2.69; 95% confidence interval (CI): -3.95, -1.42; P < 0.0001, I2 = 96%]. Ketamine also improved sleep quality on the second postoperative day (MD: -2.45; 95% CI: -3.99, -0.91; P = 0.002, I2 = 96%) and during the first three postoperative days (MD: -2.90; 95% CI: -4.79, -1.00; P = 0.003, I2 = 97%). In addition, ketamine reduced Visual Analogue Scale scores for pain (MD: -0.38; 95% CI: -0.55, -0.21; P < 0.00001, I2 = 84%). These results suggest that ketamine reduces PSDs and pain without significantly increasing adverse reactions. However, given the high heterogeneity and limited quality of evidence in this review, the results should be interpreted with caution.
Conclusion: This meta-analysis indicates that administering ketamine during the perioperative period can enhance postoperative sleep quality. However, the optimal dose, timing and method of administration remain undetermined, emphasising the need for further research to establish standardised guidelines.
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