Patients undergoing gynecological surgery are at high risk of developing postoperative sleep disorders. Intraoperative opioid use is detrimental to the patient's postoperative recovery of gastrointestinal function. Esketamine has sedative, hypnotic, analgesic, inflammatory response suppression, and antidepressant effects. Its hypnotic mechanism may be related to its rapid blockade of NMDA receptors and hyperpolarization-activated cyclic nucleotide-gated cation channels. Also can reduce the application of perioperative opioids, which in turn promotes the recovery of gastrointestinal function in patients after surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
138
The corresponding esketamine dose for each group was used at the end of anesthesia induction, and esketamine was changed to the corresponding maintenance dose for each group prior to surgical skin incision.
the Affiliated Hospital of Yangzhou University
Yangzhou, Jiangsu, China
Changes in the level of actigraphy
Through the actigraphy, monitor the patient's sleep quality.
Time frame: Baseline (the night before surgery), postoperative nights 1 and 2
Changes in the level of Pittsburgh sleep quality index
Assess the patient's sleep quality by asking questions on the scale on a scale of 0-21, with higher scores representing poorer sleep quality.
Time frame: Baseline (the night before surgery), postoperative nights 1, 2 and 3
Changes in the level of Mean Arterial Pressure
The outcome above should be measured at the time before induction, after loading dose of intervention, at the beginning of surgery, upon surgery completion, immediately after extubation, and 30min after transfer to the post-anesthesia care unit.
Time frame: Baseline (before induction), after loading dose of intervention, at the beginning of surgery, upon surgery completion, immediately after extubation, and 30min after transfer to the post-anesthesia care unit
Changes in the level of IL-6
The above results should be measured preoperatively, upon surgery completion, and on the 1st postoperative day.
Time frame: Preoperatively, upon surgery completion, postoperative day 1
Changes in the level of Melatonin
The above results should be measured preoperatively, upon surgery completion, and on the 1st postoperative day.
Time frame: Preoperatively, upon surgery completion, postoperative day 1
Changes in the level of BDNF
The above results should be measured preoperatively, upon surgery completion, and on the 1st postoperative day.
Time frame: Preoperatively, upon surgery completion, postoperative day 1
Changes in the level of IL-10
The above results should be measured preoperatively, upon surgery completion, and on the 1st postoperative day.
Time frame: Preoperatively, upon surgery completion, postoperative day 1
Changes in the level of Heart Rate
The outcome above should be measured at the time before induction, after loading dose of intervention, at the beginning of surgery, upon surgery completion, immediately after extubation, and 30min after transfer to the post-anesthesia care unit.
Time frame: Baseline (before induction), after loading dose of intervention, at the beginning of surgery, upon surgery completion, immediately after extubation, and 30min after transfer to the post-anesthesia care unit
Changes in the level of Oxygen saturation
The outcome above should be measured at the time before induction, after loading dose of intervention, at the beginning of surgery, upon surgery completion, immediately after extubation, and 30min after transfer to the post-anesthesia care unit.
Time frame: Baseline (before induction), after loading dose of intervention, at the beginning of surgery, upon surgery completion, immediately after extubation, and 30min after transfer to the post-anesthesia care unit
Changes in the level of the visual analogue scale
Assess the patient's pain by asking on a scale of 0-10, with higher scores representing more severe pain.
Time frame: Postoperative days 1 and 2
Recovery of gastrointestinal function
Record the time of the first postoperative exhausting
Time frame: Postoperative first 1 day
Recovery of gastrointestinal function
Record the time of the first postoperative bowel movement
Time frame: Postoperative first 1 day
Recovery of gastrointestinal function
Record the time of the first postoperative feeding
Time frame: Postoperative first 1 day
Postoperative adverse reactions
Record the occurrence of adverse reactions (nausea and vomiting, nightmares, dizziness, and mirages) on the 1st postoperative day.
Time frame: Postoperative day 1
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