Tingting Li,1,* Liuhu Han,2,3,* Zhen Wu,1 Yanfang Chen,1 Yiqiao Wang1 

1Department of Anesthesiology, Anhui No.2 Provincial People’s Hospital, Hefei, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 3Department of Anesthesiology, Anhui Medical University, Hefei, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yiqiao Wang, Department of Anesthesiology, Anhui No.2 Provincial People’s Hospital, North Second Ring, Yaohai District, Hefei, Anhui, People’s Republic of China, Tel +86 158 5694 0528, Email wyq20188@163.com

Purpose: This study aimed to explore the effect of preoperative different doses of esketamine on postoperative recovery in patients undergoing gynecologic laparoscopic surgery.
Methods: A total of 99 women scheduled for gynecologic laparoscopic surgery under general anesthesia were enrolled and randomized. Three minutes before surgical incision, patients in the three groups were intravenously administered 0.25 mg/kg esketamine, 0.5 mg/kg esketamine, and an equivalent dose of saline, respectively. The primary outcome was the Quality of Recovery-15 (QoR-15) score assessed on 1 day (pod1), 3 days (pod3), and 7 days postoperatively (pod7). Secondary outcomes encompassed the VAS score, MAP, HR, frequency of rescue analgesia and length of hospital stay.
Results: Compared with group C, QoR-15 score was significantly improved in group E1 and E2 on pod1, while the rest VAS score was significantly decreased at 6h postoperatively (F = 19.164, P < 0.001; F = 6.059, P = 0.034). On pod1, the VAS scores at rest and movement in group E2 were significantly lower than those in group C (P = 0.007, P = 0.038). There was a significant decrease in resting VAS scores in the E2 group compared with group C on pod3 (P = 0.021). Compared with group C, the QoR-15 score in group E2 increased on pod7 (P = 0.008), but there was no clinical difference. There was no significant difference in MAP and HR among the three groups at each time point (F = 0.758, P = 0.471; F = 0.232, P = 0.794). There was a significant difference in the number of postoperative rescue analgesia among the three groups (P = 0. 023).
Conclusion: Preoperative single small dose of esketamine can improve the quality of recovery 24h after gynecologic laparoscopic surgery patients, decrease the number of rescue analgesia, and may contribute to the rapid recovery of patients. And 0.5 mg/kg esketamine seems to be better.

Keywords: Esketamine, postoperative quality of recovery, gynecology, laparoscopic surgery