Effects of intraoperative esketamine addition on gastrointestinal function after benign gynaecological laparoscopic surgery: a double-blind, randomized controlled study

BMC Anesthesiology

Research

Ran Zhang¹  Jie Ren²  Xue Cao²  Weiwei Ma²  Yuhua Ma²  Suozhu Bao²  Lin Zhang² 

[1] Department of Anesthesiology, Peking University People’s Hospital, 100044, Beijing, China;Department of Anesthesiology, Xing’an Meng People’s Hospital, Inner Mongolia Autonomous Region, 137400, Xing’an Meng, Inner Mongolia, China;

关键词: Esketamine;    Opioid-sparing anaesthesia;    Laparoscopic surgery;    Benign gynaecological lesions;    Gastrointestinal function;   

DOI  :  10.1186/s12871-023-02184-z

 received in 2023-01-11, accepted in 2023-06-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundGastrointestinal hypokinesis can occur transiently after benign gynecologic surgery. Opioids cause the side effect of postoperative gastrointestinal hypokinesis, but an opioid-sparing anaesthetic protocol based on esketamine reduces intraoperative opioid consumption. Therefore, this study hypothesised that an opioid-sparing anaesthetic protocol based on esketamine would shorten the gastrointestinal function recovery time after benign gynaecological laparoscopic surgery.MethodsThis was a prospective randomized controlled double-blind study conducted in a single centre. All patients scheduled for elective benign laparoscopic gynaecological surgery at Xing’an Meng People’s Hospital, Inner Mongolia Autonomous Region, from November 2021 to April 2022 were consecutively enrolled and randomly divided into the opioid-sparing anaesthesia group (Group OS) and the conventional anaesthesia group (Group C). Postoperative first exhaust time, feeding time and postoperative nausea and/or vomiting (PONV) were analyzed in both groups.ResultsA total of 71 patients were enrolled in this study, including 35 in Group OS and 36 in Group C. The general condition, operative time, type of surgery, intraoperative bleeding, intraoperative fluid volume and intraoperative urine volume were not statistically different between the two groups. Compared with Group C, significantly shorter first postoperative flatus time (11 [8, 14] h vs. 14 [11, 18], p = 0.003) and anaesthesia resuscitation time (7 [6, 9] h vs. 9 [7, 11] h, p = 0.013)were observed in the OS group. The incidence of PONV in Group OS was significantly lower compared with Group C (11.4% vs. 41.7%, p = 0.007).ConclusionThe esketamine-based opioid-sparing anaesthetic protocol can shorten the postoperative first flatus time after benign laparoscopic surgery in gynaecology, and reduce the incidence of PONV. In addition, the application of esketamine may reduce the postoperative opioid dose requirement of patients.Trial registration: This study was registered with the China Clinical Trials Registry (registration number: ChiCTR2100052528, 30/10/2021).

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 3