Effect of a Subanesthetic Dose of Esketamine on Postoperative Sleep Disturbance After Oocyte Retrieval Under Intravenous Anesthesia: A Randomized Controlled Trial.

In 30 seconds

This randomized, double-blind, placebo-controlled trial assessed whether intravenous esketamine reduces postoperative sleep disturbance (PSD) in women undergoing oocyte retrieval with intravenous anesthesia. Participants received esketamine 0.2 mg/kg or saline at induction. In the intention-to-treat analysis, estimated PSD incidence on postoperative day 3 was 13.06% with esketamine versus 24.90% with control (risk difference, -11.84 percentage points [95% CI, -22.98 to -0.69]; RR, 0.52 [95% CI, 0.28-0.99]; P = 0.047). PSD on day 1 did not differ. Esketamine was also associated with more dreaming and modestly longer recovery measures.

Key findings

• On postoperative day 3, estimated PSD incidence was 13.06% with esketamine versus 24.90% with control (RR, 0.52; P = 0.047).
• PSD incidence on postoperative day 1 and postoperative anxiety and depression scores did not differ between groups.
• Pain scores at 30 minutes were lower with esketamine (P < 0.001), while dreaming was more frequent (21.4% vs 11.2%; P = 0.048).
• Time to full alertness and PACU stay were modestly longer with esketamine: 12 [10-14] vs 11 [9-13] minutes and 34 [30-37] vs 31 [29-34] minutes.

Why it matters

Sleep disturbance is a reported postoperative complication in this setting, and the trial suggests a single subanesthetic esketamine dose may reduce its incidence by postoperative day 3. The findings also show trade-offs, including more frequent dreaming and slightly longer recovery measures. Together, these outcomes provide clinically relevant evidence for evaluating both sleep and recovery effects of esketamine in this population.

What to keep in mind

The study assessed short-term outcomes in women undergoing oocyte retrieval; the authors state that larger multicenter studies are needed to confirm the findings.