Effect of Subanesthetic Dose of Esketamine on Sleep Quality and Recovery of Gastrointestinal Function in Patients Undergoing General Anesthesia Laparoscopic Uterine Surgery in the Early Postoperative Period
Study Details
Study Description
Brief Summary
Patients undergoing gynecological surgery are at high risk of developing postoperative sleep disorders. Intraoperative opioid use is detrimental to the patient's postoperative recovery of gastrointestinal function. Esketamine has sedative, hypnotic, analgesic, inflammatory response suppression, and antidepressant effects. Its hypnotic mechanism may be related to its rapid blockade of NMDA receptors and hyperpolarization-activated cyclic nucleotide-gated cation channels. Also can reduce the application of perioperative opioids, which in turn promotes the recovery of gastrointestinal function in patients after surgery.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Esketamine for induction 0.2mg/kg and maintenance 0.2mg/kg/h
|
Drug: esketamine
The corresponding esketamine dose for each group was used at the end of anesthesia induction, and esketamine was changed to the corresponding maintenance dose for each group prior to surgical skin incision.
|
Experimental: Esketamine for induction 0.3mg/kg and maintenance 0.3mg/kg/h
|
Drug: esketamine
The corresponding esketamine dose for each group was used at the end of anesthesia induction, and esketamine was changed to the corresponding maintenance dose for each group prior to surgical skin incision.
|
No Intervention: No esketamine
|
Outcome Measures
Primary Outcome Measures
- Changes in the level of actigraphy [The 1st night before the operation and the 1st and 2nd nights postoperatively]
Through the actigraphy, monitor the patient's sleep quality
- Changes in the level of Pittsburgh sleep quality index [The day before surgery and 1,2,3,7 days]
Assess the patient's sleep quality by asking questions on the scale
Secondary Outcome Measures
- Changes in the level of Systolic Blood Pressure/Diastolic Blood Pressure(Mean Arterial Pressure) [Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation]
The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation
- Changes in the level of IL-6 [Preoperative, 6 hours postoperative, 24 hours postoperative]
The above results should be measured preoperatively, 6 hours postoperatively, and 24 hours postoperatively.
- Changes in the level of Melatonin [Preoperative, 6 hours postoperative, 24 hours postoperative]
The above results should be measured preoperatively, 6 hours postoperatively, and 24 hours postoperatively.
- Changes in the level of CRP [Preoperative, 6 hours postoperative, 24 hours postoperative]
The above results should be measured preoperatively, 6 hours postoperatively, and 24 hours postoperatively.
- Changes in the level of TNF [Preoperative, 6 hours postoperative, 24 hours postoperative]
The above results should be measured preoperatively, 6 hours postoperatively, and 24 hours postoperatively.
- Changes in the level of Heart Rate [Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation]
The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation
- Changes in the level of Oxygen saturation [Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation]
The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation
- Changes in the level of the visual analogue scale [6 hours, 12 hours, 24 hours, 48 hours after surgery]
Assess the patient's pain by asking
- Recovery of gastrointestinal function [Postoperative first 1 day]
Record the time of the first postoperative exhausting
- Recovery of gastrointestinal function [Postoperative first 1 day]
Record the time of the first postoperative bowel movement
- Recovery of gastrointestinal function [Postoperative first 1 day]
Record the time of the first postoperative feeding
- Postoperative adverse reactions [The first, second and third day after surgery]
Record the occurrence of adverse reactions (nausea, vomiting, hallucinations, abdominal distension) on the first, second and third postoperative days
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age ≥ 40 years;
-
ASA class I-III;
-
Proposed laparoscopic total hysterectomy/myomectomy;
-
Operative time ≥ 1 h.
Exclusion Criteria:
- patient refusal;
-
known allergy to anesthetic drugs;
-
chronic use of opioids or sedative-hypnotic drugs;
-
history of psychiatric or neurological disease;
-
previous or planned neurosurgical procedures;
-
hearing or visual impairment that precludes a scale assessment.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | the Affiliated Hospital of Yangzhou University | Yangzhou | Jiangsu | China |
Sponsors and Collaborators
- Zhuan Zhang
Investigators
- Principal Investigator: zhuan zhang, professor, The Affiliated Hospital of Yangzhou University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 20221217