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Intraoperative Esketamine Is Effective at Reducing Acute Postoperative Pain in Bariatric Surgery Patients: a Randomized Control Trial

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Abstract

Background

The analgesic effect and postoperative effects of esketamine are not yet clear in bariatric surgeries. Many bariatric surgery patients suffer from acute abdominal pain after surgery which leads to increased opioid use. This study aimed to determine whether intraoperative use of esketamine could reduce acute postoperative pain in bariatric surgery patients.

Methods

We designed a randomized double-blinded controlled trial. Included patients between the ages of 18 and 50 years with a body mass index ≥27 kg/m2 and American Society of Anesthesiologists Physical Status of I-III, scheduled to undergo sleeve gastrectomy. We divided them into two groups, the control group which received a placebo, and the esketamine group which received a loading dose of esketamine 0.2 mg/kg and a maintenance dose of 0.2 mg/(kg·h) along with other anesthetic drugs during the surgery. After the surgery, they were assessed for Numerical Rating Scale (NRS) pain scores and Post Operative Nausea and Vomiting (PONV) scores, while other surgical data were recorded during the surgery.

Results

We enrolled 68 patients, 52 females, and 16 males. The 0.5 h, 1 h, 2 h, 6 h, and 12 h NRS scores were significantly lower in the esketamine group compared to the control group, and the extra painkillers administered were significantly lower in the esketamine group (p<0.05).

Conclusion

Intraoperative use of esketamine can reduce acute postoperative pain in bariatric surgery patients. Further studies should explore whether the reduced pain is due to the anti-depressive effect of esketamine or purely the analgesic effect.

Trial registration

Chinese Clinical Trial Registry (ChiCTR2100054038, https://www.chictr.org.cn/com/25/showproj.aspx?proj=142806)

Graphical Abstract

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Data Access Statement

Supplementary data can be accessed online at https://doi.org/10.17632/cxtkvr786g.1.

Funding

This work was supported by the Sichuan Informatics Association of Tradition Chinese Medicine [5101075642792].

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Chengdu Third People’s Hospital Affiliated to Southwest Jiaotong University, Chengdu, 610000, Sichuan, China

    Ting Yang, Mingxing Xu & Qiang Fu

  2. Department of Cardiovascular Medicine, West China Hospital, Sichuan University, #37 Guoxue Alley, Wuhou District, Chengdu, 610000, Sichuan Province, China

    Muhammad Saqib Mudabbar

  3. Department of Anesthesiology, West China Hospital, Sichuan University, #37 Guoxue Alley, Wuhou District, Chengdu, 610000, Sichuan Province, China

    Bin Liu

Authors
  1. Ting Yang
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Contributions

T.Y. designed the study, collected the data, and wrote the manuscript. M.S.M. wrote the manuscript and analyzed the data. M.X.X. collected the data. B.L. and Q.F. supervised the study. T.Y. and M.S.M. have contributed equally to this work.

Corresponding author

Correspondence to Qiang Fu.

Ethics declarations

Human and Animal Rights/Ethical Approval

This study was approved by the Ethics Committee of Chengdu Third People’s Hospital (approval number 713, 2021).

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• Esketamine can reduce acute postoperative pain in bariatric surgery patients.

• Use of extra painkillers in the ICU for the first 48 h was significantly lower.

• Intraoperative esketamine did not cause any adverse side effects at 0.2 mg/(kg·h).

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Yang, T., Mudabbar, M.S., Liu, B. et al. Intraoperative Esketamine Is Effective at Reducing Acute Postoperative Pain in Bariatric Surgery Patients: a Randomized Control Trial. OBES SURG 33, 2368–2374 (2023). https://doi.org/10.1007/s11695-023-06676-2

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  • DOI: https://doi.org/10.1007/s11695-023-06676-2

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