Esketamine during anesthesia induction improves early postoperative sleep quality in female patients undergoing...

To evaluate the effect of intravenous esketamine administration during anesthesia induction on postoperative sleep quality in female patients undergoing laparoscopic surgery.

This study was designed as a prospective, double-blind, single-center randomized controlled trial and was conducted at Huzhou Maternity & Child Health Care Hospital between December 5, 2025, and January 31, 2026. One hundred ASA I-II female patients (25-50 years) undergoing elective laparoscopic surgery (Dec 2025-Jan 2026) were randomized to control (Group C, n=50) or esketamine (Group S, n=50). Both groups received propofol 2 mg/kg, cisatracurium 0.15 mg/kg, and sufentanil 0.3 μg/kg for induction; Group-S additionally received esketamine 0.3 mg/kg, while Group-C received normal saline. Anesthesia was maintained with propofol (4-6 mg/kg/h) and remifentanil (0.1-0.2 μg/kg/min) via infusion pumps to maintain the Bispectral Index (BIS) between 40 and 60 and end-tidal carbon dioxide (PETCO₂) between 35 and 45 mmHg. Outcomes included Pittsburgh Sleep Quality Index (PSQI) on postoperative days (POD) one, three, seven; intraoperative sufentanil use; 6/24 h VAS pain scores; 24 hours rescue analgesia rate; adverse events; emergence time; and PACU stay.

Ninety eight patients (Group C: 49; Group S: 49) completed the study. Group-S had lower PSQI scores on POD one and three (P<0.05), reduced intraoperative sufentanil consumption (P<0.05), lower 6/24 hours VAS scores (P<0.05), and lower 24 hours rescue analgesia rate (P<0.05). No significant differences in emergence time, PACU duration, or adverse event rates were observed (P>0.05), with no severe adverse events.

Administration of 0.3 mg/kg esketamine during anesthesia induction reduces opioid consumption, improves early postoperative sleep quality, and decreases sleep disturbance incidence in female laparoscopic patients without increasing adverse event risks.