Effect of low-dose esketamine on postoperative sleep quality in patients undergoing breast cancer surgery
Objective To investigate the effect of intravenous inject esketamine 0.25 mg/kg before surgery on postoperative sleep quality in breast cancer patients.Methods Seventy female patients under elective general anesthesia for radical mastectomy,aged 35-64 years,BMI 18.5-34.0 kg/m2,ASA physi-cal status Ⅰ or Ⅱ were selected.The patients were divided into two groups using the random number table method:esketamine group(group E)and control group(group C),35 patients in each group.Group E re-ceived an intravenous injection of esketamine 0.25 mg/kg during anesthesia induction,while group C re-ceived a constant volume of saline.Subjective sleep quality was assessed using the Richards Campbell sleep questionnaire(RCSQ)1 day before surgery and 1 day to 3 days after surgery,and sleep efficiency as well as the proportion of light,deep,and rapid eye movement(REM)sleep time were recorded using the weara-ble device Fitbit.Pain was assessed by the VAS pain score at 1 day to 3 days after surgery.Time of extuba-tion,remifentanil dosage,number of remedial analgesia cases,and adverse effects such as nausea and vom-iting and dizziness were recorded.Results Compared with 1 day before surgery,the RCSQ scores and sleep efficiency were significantly lower in both groups 1 day to 3 days after surgery(P＜0.05),and the proportion of deep sleep and REM sleep was significantly lower and the proportion of light sleep was signifi-cantly higher in group C(P＜0.05).Compared with group C,RCSQ scores,sleep efficiency,the propor-tion of deep and REM sleep time were significantly higher(P＜0.05),and the proportion of light sleep time was significantly lower in group E 1 day to 3 days after surgery(P＜0.05),VAS pain scores were sig-nificantly lower 1 day to 3 days after surgery(P＜0.05).There was no significant difference in the time of extubation,remifentanil dosage,number of remedial analgesia cases,and adverse effects between the two groups.Conclusion Intravenous injection of esketamine 0.25 mg/kg before surgery can improve postopera-tive sleep quality and reduce postoperative pain in breast cancer patients,and no increase in adverse effects.
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