Effects of sub-anesthetic doses of esketamine on immune function and postoperative negative emotions in acoustic neuroma patients: a randomized clinical trial.
Zheping Chen, Yaozhu Wang, Peilin Cong, Lifeng Wang, Pengcheng Sun, Zhenzhen Li, He Zhang, Guiting Li, Fengmei Jiao, Juan Zhao, Linyan Li, Yuelong Jin, Qianqian Wu, Li Tian, Yanwu Jin
Annals of medicine July 3, 2026 DOI: 10.1080/07853890.2026.2692804 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 77 |
| Population | Patients undergoing acoustic neuroma surgery |
| Intervention | Esketamine |
| Dose | 0.2 mg·kg-1·h-1 continuous intravenous infusion during anesthesia, followed by 1 mg·kg-1 as an adjuvant in patient-controlled intravenous analgesia |
| Duration | Perioperative period with follow-up through postoperative day 3 |
| Topics | Anxiety Depression Esketamine |
| Keywords | Negative emotion Sleep disturbance |
| Key findings | Perioperative sub-anesthetic esketamine reduced postoperative depression, anxiety, and sleep disturbances after acoustic neuroma surgery, but did not significantly affect early immune function or acute postoperative analgesia. |
Abstract
Patients undergoing acoustic neuroma (AN) surgery often experience postoperative negative emotions, including anxiety, depression, and immune function suppression. This trial evaluated whether perioperative sub-anesthetic esketamine improves early postoperative negative emotions and immune function. In this single-center, double-blind, randomized trial, 84 patients scheduled for AN surgery were assigned to esketamine (n = 42) or placebo (n = 42). The esketamine cohort received a continuous intravenous infusion of esketamine at 0.2 mg·kg-1·h-1 during anesthesia, followed by 1 mg·kg-1 esketamine as an adjuvant in patient-controlled intravenous analgesia (PCIA). The placebo group received saline. The primary outcome was the incidence of depression on postoperative day (POD1), defined as a Hospital Anxiety and Depression Scale-Depression subscale (HADS-D) score > 7. Seventy-seven patients completed the study (39 in the esketamine group, 38 in the placebo group). Esketamine significantly reduced the incidence of depression at POD1 (7.7% versus 31.6%; relative risk 0.24, 95% CI: 0.08-0.80, p = 0.008) and POD3 (0.0% versus 15.8%, relative risk 0.00, 95% CI: 0.00-0.47, p = 0.031) compared with placebo. The incidences of anxiety on POD1 and 3 and sleep disturbances on POD1 were also significantly reduced (p < 0.05). Notably, no significant differences were observed between the two groups in terms of immune function, postoperative pain scores, or intraoperative morphine equivalent. Adverse events did not differ between the groups. Perioperative sub-anesthetic esketamine reduced postoperative depression and anxiety, and improve sleep quality after AN surgery, without significant effects on early immune function or acute postoperative analgesia. Chinese Clinical Trial Registry, ChiCTR2400084537.
In the evidence
This study is part of the evidence base for 3 syntheses in the library. Here is how each one recorded it.
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Perioperative sub-anesthetic esketamine reduced postoperative depression, anxiety, and sleep disturbances compared with placebo, without significantly affecting immune function or analgesia.
Synthesized
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Perioperative sub-anesthetic esketamine reduced the incidence of anxiety on postoperative days 1 and 3 compared with placebo, but did not significantly affect early immune function or acute postoperative analgesia.
Synthesized
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State of the evidence: Esketamine Supports
Perioperative sub-anesthetic esketamine reduced postoperative depression, anxiety, and sleep disturbances after acoustic neuroma surgery, but did not significantly affect early immune function or acute postoperative analgesia.
Synthesized
Comparable studies
Other randomized controlled trials on esketamine for anxiety, most cited first.