Trial reportInternational journal of surgery (London, England)2026
Effect of intraoperative low-dose esketamine on postoperative quality of recovery in patients undergoing laparotomy for gynecologic malignancy: a randomized controlled trial.
Trial report in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Esketamine for Postoperative Anxiety After Major Abdominal Tumor Surgery: A Randomized Clinical Trial.Drug design, development and therapy · 2026Trial
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGynecologic malignancy surgery with long midline incision and extensive surgical field often causes severe pain. We aimed to evaluate the benefit of low-dose esketamine on postoperative recovery after gynecologic malignancy laparotomy. MATERIALS AND
methodsIn total, 140 female patients scheduled for elective gynecologic malignancy laparotomy were randomly assigned to the esketamine group ( n = 70) or control group ( n = 70). Patients in the esketamine group received an intraoperative infusion of 0.25 mg/kg/h esketamine while those in the control group received an equivalent volume of saline. Both groups received a standard multimodal analgesic regimen that consisted of transversus abdominis plane block, acetaminophen, nonsteroidal anti-inflammatory drugs, and patient-controlled morphine. The primary outcome was the Quality of Recovery-40 (QoR-40) score at 48 hours postoperatively. Secondary outcomes included morphine consumption, pain scores, adverse effects, time to post-anesthesia care unit (PACU) discharge, postoperative depressive symptom on postoperative day 7, quality of life, and chronic pain at 3 months after surgery.
resultsThe median QoR-40 score at 48 hours was 179 (164-190) in the esketamine group, which was not significantly different from 178.5 (163-186) in the control group (median difference, 1; 95% CI, -4 to 7; P = 0.643). Secondary outcomes were comparable between the two groups. Patients in the esketamine group had more over-sedation (20/69 [29.0%] vs. 8/70 [11.4%]; absolute risk difference (ARD), 17.6% [95% CI, 4.2-30.4%]; P = 0.010), and delayed discharge from PACU (19/69 [27.5%] vs. 4/70 [5.7%]; ARD, 21.8% [95% CI, 9.6-33.8%]; P = 0.001) compared to the control group.
conclusionsIntraoperative low-dose esketamine failed to further improve the QoR-40 score after gynecologic malignancy laparotomy when used as part of a multimodal analgesic regimen. Further research is needed to explore the optimal dosage and indications of esketamine in this patient population.
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