Evidence map›Paper›PMID 40855477›Full record

Observational studyBMC anesthesiology2025

Esketamine/dexmedetomidine-based opioid-free anesthesia and its association with postoperative bowel and cognitive dysfunction after total laparoscopic hysterectomy.

Guohua Li, Yingbing Lv, Song Gao, Xinyu Yao, Shaohui Ren, Liyuan Dong, Xiao Li

Abstract readObservational Study
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Guohua LiDepartment of Anesthesiology, Xingtai People's Hospital, Xingtai, Heibei, 054001, China.
Yingbing LvDepartment of Anesthesiology, Xingtai People's Hospital, Xingtai, Heibei, 054001, China.
Song GaoOperating Room, Xingtai People's Hospital, Xingtai, Heibei, 054001, China.
Xinyu YaoDepartment of Anesthesiology, Xingtai People's Hospital, Xingtai, Heibei, 054001, China.
Shaohui RenDepartment of Science and Education, Xingtai People's Hospital, Xingtai, Heibei, 054001, China.
Liyuan DongDepartment of Obstetrics, Xingtai People's Hospital, Xingtai, Heibei, 054001, China.
Xiao LiDepartment of Gynecology, Xingtai People's Hospital, 145 Xinhua North Road, Xiangdu District, Xingtai, 054001, Heibei, China. lixiaohb00@163.com.

Funding

Hebei Provincial Health Commission 20251414
6 · The paper itself

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.

Indexed as

DexmedetomidineHysterectomyKetamineLaparoscopyPostoperative Cognitive ComplicationsPostoperative ComplicationsAdultAnalgesics, OpioidCohort StudiesFemaleHumansIleusMiddle AgedPostoperative PainProspective StudiesAnalgesics, OpioidDexmedetomidineEsketamineKetamineCognitive functionDexmedetomidineEsketamineOpioid-Free anesthesiaPostoperative bowel function

Identifiers

PMID40855477
PMCPMC12379542

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.