Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy.
Xingyu Geng, Yutian Pu, Ziwei Hu, Heling Zhang, Maosan Wang, Can Fang, Gaochao Lv, Wanting Li, Xinyue Zhang, Xiaoxuan Fan, Su Liu, Xiuxia Chen, Jingru Wu
Drug Design, Development and Therapy 2025 DOI: 10.2147/DDDT.S510222 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 100 |
| Population | Breast cancer patients after surgery |
| Interventions | Esketamine Dexmedetomidine Esketamine combined with dexmedetomidine |
| Duration | First three postoperative days |
| Topics | Esketamine |
| Keywords | Dexmedetomidine Sleep disturbance Sleep medicine Post-surgical recovery Sleep disorders Breast cancer treatment Anesthesia medication |
| Citations | 7 |
| Key findings | Intraoperative esketamine combined with dexmedetomidine did not significantly reduce the incidence of postoperative sleep disturbance, but dexmedetomidine reduced REM sleep and esketamine reduced nocturnal awakening time. |
Abstract
Postoperative sleep disturbance(POSD) is a problem in breast cancer patients after surgery. Little is known about the differences in the treatment of POSD with esketamine combined with dexmedetomidine under the same circumstances. We investigated the effects of intraoperative esketamine combined with intravenous dexmedetomidine on the incidence of POSD and postoperative sleep architecture. A single-center, randomized, double-blind controlled trial was conducted. A total of 100 participants were randomly assigned to four groups: the esketamine group (Group E), the dexmedetomidine group (Group D), the esketamine combined with dexmedetomidine group (Group ED), and the control group (Group S) (n=25 each). The intervention drugs were continuously infused until the placement of the drainage tube. The primary outcome measure was the incidence of POSD, defined as an Athens Insomnia Scale (AIS) score >6 on at least one of the first three postoperative days. The secondary outcome measure was the duration of sleep structure, which was collected using the Fitbit Charge 2® smartwatch (Fitbit, Inc. San Francisco, California, USA). In the first three postoperative days, the incidence of POSD was similar across the four groups (P=0.947). However, on postoperative day 3 (POD3), there was a significant interaction between esketamine and dexmedetomidine (P=0.004). Further simple effect analysis revealed that, in the absence of esketamine, dexmedetomidine had a significant effect on POSD on POD3 (OR=0.196, [0.056-0.691]; P=0.019). In the absence of dexmedetomidine, esketamine had a significant effect on POSD on POD3 (OR=0.248, [0.074-0.833]; P=0.042). Dexmedetomidine reduced rapid eye movement (REM) sleep on postoperative day 1 (P=0.042). Esketamine reduced nighttime awakening time on POD1 (P=0.036) and POD3 (P=0.020). Intraoperative infusion of esketamine combined with dexmedetomidine had no significant effect on POSD, but dexmedetomidine reduced REM sleep, and esketamine reduced the nocturnal awakening time.
Comparable studies
Other randomized controlled trials on esketamine, most cited first.
Citations in the library
Cites 10
- NMDAR inhibition-independent antidepressant actions of ketamine metabolites Nature April 24, 2016
- Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor Molecular Psychiatry May 7, 2021
- Molecular mechanisms of the rapid-acting and long-lasting antidepressant actions of (R)-ketamine. Biochemical Pharmacology July 1, 2020
- Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial. BMJ April 10, 2024
- Effect of Ketamine on Sleep in Treatment-Resistant Depression: A Systematic Review Pharmaceuticals April 1, 2023
and 5 more in the library