Evidence map›Paper›PMID 41409261›Full record

Trial reportDrug design, development and therapy2025

Effects of Subanesthetic Esketamine on Postoperative Sleep Quality Through EEG Analysis in Breast Cancer Patients: A Randomized Clinical Trial.

Yuening Zhan, Yanmei Zhang, Zhaohui Liu, Zheng Yin, Dan Wang, Xin Xie, Lingfei Wang

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Drug design, development and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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.

Yuening Zhan *Department of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.
Yanmei Zhang *Department of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.
Zhaohui LiuDepartment of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.ORCID 0000-0001-7246-7548
Zheng YinDepartment of Orthopedics, Anshan Hospital, The First Hospital of China Medical University, Anshan, Liaoning, People's Republic of China.
Dan WangDepartment of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.
Xin Xie *Department of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.
Lingfei Wang *Department of Anesthesiology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, People's Republic of China.ORCID 0009-0005-5376-4551

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Postoperative sleep disturbance (POSD) is prevalent following breast cancer surgery, impairing postoperative recovery. However, effective interventions and underlying mechanisms remain unclear. This study aims to evaluate whether intravenous subanesthetic esketamine improves postoperative sleep quality and its association with electroencephalogram (EEG) frequency band changes in breast cancer patients. Methods: In this randomized, double-blind, placebo-controlled trial, patients undergoing breast cancer surgery received either intravenous esketamine (0.2 mg/kg induction, 0.4 mg/kg/h maintenance) or placebo during anesthesia. Both groups received intraoperative EEG monitoring. The primary outcome was POSD incidence at 24 hours assessed by the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included PSQI scores at 72 hours, Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores, Visual Analog Scale (VAS) pain scores, and intraoperative EEG parameters. Results: POSD incidence was significantly reduced in the esketamine group compared with the control group (27.3% [16/58] vs 51.7% [30/58]; odds ratio, 0.36; 95% CI, 0.16-0.77; P = 0.014). Moreover, the esketamine group demonstrated significantly lower PSQI scores at both 24 hours (median [IQR], 2 [1-5] vs 4 [4-8]; P < 0.001) and 72 hours (1 [0-2.5] vs 3.5 [2.75-5]; P < 0.001). The esketamine group exhibited significantly higher intraoperative gamma-band relative power spectral density (mean [SD], 0.74 [0.25] vs 0.52 [0.18]; P < 0.001), which was independently associated with reduced POSD risk in multivariate analysis (odds ratio, 0.63; 95% CI, 0.40-0.97; P = 0.039). Conclusion: Subanesthetic esketamine significantly reduced the incidence of POSD and lowered PSQI scores. Importantly, esketamine was associated with enhanced intraoperative gamma-band EEG activity, which was independently associated with reduced POSD risk, suggesting that modulation of specific cortical oscillations may underlie its sleep-enhancing effects. Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2400092257.

Indexed as

Breast NeoplasmsElectroencephalographyKetaminePostoperative ComplicationsSleep QualitySleep Wake DisordersAdultAgedDouble-Blind MethodFemaleHumansMiddle AgedEsketamineKetaminebreast cancer surgeryelectroencephalogramgamma oscillationspostoperative sleep disturbancesubanesthetic esketamine

Identifiers

PMID41409261
PMCPMC12707242

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.