Effect of a Single Subanesthetic Dose of Esketamine on Gastrointestinal Recovery After Laparoscopic Colorectal Cancer Surgery: A Randomized, Outcome-Assessor-Blinded, Placebo-Controlled Trial.
Zhenye Zhang, Jun Liu, Ping Xiang et al.
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From the abstract
Postoperative gastrointestinal dysfunction (POGD) and Postoperative gastrointestinal intolerance (POGI) remain a critical challenge in abdominal surgery, particularly for colorectal cancer patients undergoing laparoscopic procedures. Current evidence suggests anesthetic agents may influence gastrointestinal recovery, yet the impact of esketamine remains underexplored.
Reported results
The esketamine group demonstrated significantly shorter time to first flatus (52 [50.25-53.75] vs 60 [58.59-61.41] hours; P < 0.001) and first defecation (87 [81.96-92.04] vs 95 [92.65-97.35] hours; P = 0.04) compared to controls. I-FEED scores were markedly lower (median 1 [0.25-2] vs 2.5 [1-3]; P < 0.001), with reduced nausea (P = 0.001) and abdominal distension duration (P < 0.001).
Authors' conclusions
Intraoperative esketamine accelerates gastrointestinal function recovery after laparoscopic colorectal surgery, especially reducing postoperative gastrointestinal intolerance symptoms of nausea and distension while improving early sleep quality. However, no evident benefit was observed in reducing hospital length of stay or patient costs.