Observational studyBMC anesthesiology2025
Esketamine/dexmedetomidine-based opioid-free anesthesia and its association with postoperative bowel and cognitive dysfunction after total laparoscopic hysterectomy.
Observational study in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Esketamine for Postoperative Multimodal Analgesia in Laparoscopic Surgery: A Systematic Review and Meta-Analysis.Journal of pain research · 2026Review
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Authors and funding
7 authors.
Funding
Abstract
backgroundOpioid-free anesthesia (OFA) protocols using esketamine and dexmedetomidine have shown potential benefits for perioperative pain control with fewer side effects. We explored whether an esketamine–dexmedetomidine OFA regimen accelerates bowel recovery and preserves cognitive function after laparoscopic total hysterectomy.
methodsIn this prospective observational cohort study, we enrolled 114 women undergoing elective total laparoscopic hysterectomy (TLH). Anesthesia technique—esketamine–dexmedetomidine–based OFA (OFA group) versus standard opioid-based anesthesia (OBA group)—was chosen by the attending anesthesiologist. Key perioperative variables, including drug dosages and rescue analgesics, were recorded. The primary outcome was the time to first bowel movement. Secondary endpoints included incidence of postoperative ileus, pain scores, opioid consumption, and postoperative cognitive function assessed by the Montreal Cognitive Assessment (MoCA) at baseline and postoperative Days 1 and 3.
resultsAmong the 114 participants (OFA group n = 59; OBA group n = 55), median time to first bowel movement was significantly shorter in the OFA group (42 h [IQR 38–48]) compared with the OBA group (49 h [IQR 42–56]; p < 0.01). Postoperative ileus occurred in 6% of OFA patients versus 15% of OBA patients (p = 0.07). Postoperative MoCA scores showed a smaller decline from baseline in the OFA group (mean difference − 1.2 ± 1.0) compared with the OBA group (− 2.3 ± 1.5; p < 0.05). Use of rescue opioids was lower in the OFA group (23% vs. 42%; p = 0.02).
conclusionsEsketamine–dexmedetomidine–based OFA approach was associated with faster return of bowel function and reduced cognitive decline compared to standard opioid-based anesthesia in women undergoing TLH, without compromising analgesia or safety. These observational findings warrant confirmation in randomized trials.
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