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Effect of esketamine on opioid consumption and postoperative pain in thyroidectomy: a randomized controlled trial
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  • Penglei Wang,
  • Meixian Song,
  • Xiaoli Wang,
  • Ye Zhang,
  • Yun Wu
Penglei Wang
Second Affiliated Hospital of Anhui Medical University

Corresponding Author:[email protected]

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Meixian Song
Second Affiliated Hospital of Anhui Medical University
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Xiaoli Wang
Second Affiliated Hospital of Anhui Medical University
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Ye Zhang
Second Affiliated Hospital of Anhui Medical University
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Yun Wu
Second Affiliated Hospital of Anhui Medical University
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Abstract

Aim: Thyroidectomy is frequently associated with substantial postoperative pain. Esketamine, an N-methyl-D-aspartate receptor antagonist, has been demonstrated to be effective in multiple analgesia. We hypothesized that intraoperative administration of esketamine may reduce perioperative opioid consumption and postoperative pain in patients undergoing thyroidectomy. Methods: Sixty patients undergoing thyroidectomy were randomly assigned to two groups. Patients in the saline group received a pre-incisional intravenous bolus of 0.9% NaCl followed by an intraoperative infusion of 0.9% NaCl; patients in the esketamine group received a pre-incisional intravenous bolus of esketamine (0.5 mg kg-1) followed by an intraoperative infusion of esketamine (0.24 mg kg-1 h-1). The primary outcome was perioperative sufentanil consumption. The postoperative pain, sleep quality, and adverse events during the first postoperative 24 h were also evaluated. Results: Patients in the esketamine group consumed significantly less sufentanil than those in the saline group (24.6 ± 3.1 μg vs. 33.7 ± 5.1 μg, mean difference, 9.1; 95% confidence interval, 6.9–11.3, P <0.001). Postoperative pain scores were significantly lower in the esketamine group than those in the saline group during the first 24 h postoperatively (P <0.05). Patients receiving esketamine experienced higher sleep quality than those in the saline group during surgical night (P = 0.043). There were no significant differences in adverse events between the two groups. Conclusion: Intraoperative administration of esketamine reduces perioperative sufentanil consumption and postoperative pain without increasing adverse events in patients undergoing thyroidectomy. The development of combined anesthesia regimens, including esketamine, may foster strategies for pain management during thyroidectomy.
30 Oct 2022Submitted to British Journal of Clinical Pharmacology
31 Oct 2022Submission Checks Completed
31 Oct 2022Assigned to Editor
31 Oct 2022Review(s) Completed, Editorial Evaluation Pending
06 Nov 2022Reviewer(s) Assigned
17 Jan 2023Editorial Decision: Revise Minor
14 Feb 20231st Revision Received
16 Feb 2023Submission Checks Completed
16 Feb 2023Assigned to Editor
16 Feb 2023Review(s) Completed, Editorial Evaluation Pending
07 Mar 2023Editorial Decision: Revise Minor
08 Mar 20232nd Revision Received
09 Mar 2023Submission Checks Completed
09 Mar 2023Assigned to Editor
09 Mar 2023Review(s) Completed, Editorial Evaluation Pending
13 Mar 2023Editorial Decision: Accept