Work

Effect of Esketamine on Perioperative Inflammatory Factors and Postoperative Analgesic Outcomes in Patients with Obstructive Sleep Apnea Syndrome: A Randomized Controlled Trial

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Purpose: The effect of esketamine on perioperative inflammatory factors and postoperative analgesic outcomes in patients with Obstructive sleep apnea syndrome (OSAS) remains unclear. This trial assesses whether 0.25 mg · kg − esketamine during general anesthesia can reduce the inflammatory level and relieve postoperative pain in OSAS patients. Patients and Methods: 96 adult patients with OSAS underwent palatopharyngoplasty under general anesthesia was included in our research. Following anesthetic introduction, subjects were randomized to either 0.25 mg · kg − esketamine (in 20mL solution; esketamine group) or an equivalent volume of saline (Control group). The primary result was the level of IL-6 and TNF-α before the infusion of esketamine, 40min, 4h, and 24h after the esketamine infusion. Secondary outcomes was NRS scores immediately after tracheal extubation, 4h after the infusion, postoperative day 1 (POD1), postoperative day 2 (POD 2) and postoperative day 7 (POD 7). Results: The esketamine group demonstrated significantly reduced IL-6 and TNF-α levels at 40 minutes post-infusion ( P < 0.001) and showed lower the numerical rating scale(NRS)scores with less rescue analgesia immediately after extubation ( P < 0.001) compared to the control group, despite prolonged extubation and post-anesthesia care unit (PACU) stay ( P < 0.001). Across POD1-2, the esketamine group maintained reduced NRS scores ( P < 0.001) and analgesic doses ( P =0.021), higher quality of recovery-15 (QoR-15) scores and patient satisfaction scores ( P < 0.001) relative to control group. It is important to note that the significant differences in inflammatory markers and pain scores between groups were not sustained at the 24-hour assessment and on postoperative day 7, respectively, indicating transient effects. Conclusion: Intraoperative infusion of 0.25 mg·kg − esketamine provided transient suppression of inflammatory responses and reduced early postoperative pain in OSAS patients. However, these benefits were exploratory and time-limited, and must be weighed against prolonged extubation and PACU stay. Keywords: esketamine, OSAS, IL-6, TNF-α, NRS

Source: Drug Design Development and Therapy

DOI: 10.2147/dddt.s562398