Volume 89, Issue 8 p. 2542-2551
ORIGINAL ARTICLE

Effect of esketamine on opioid consumption and postoperative pain in thyroidectomy: A randomized controlled trial

Penglei Wang

Penglei Wang

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China

Contribution: Formal analysis, Conceptualization, Methodology, Software, Writing - original draft

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Meixian Song

Meixian Song

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China

Contribution: Conceptualization, Funding acquisition, Methodology, Software, Writing - original draft

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Xiaoli Wang

Xiaoli Wang

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China

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Ye Zhang

Corresponding Author

Ye Zhang

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China

Correspondence

Yun Wu and Ye Zhang, Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui Province, China.

Email: [email protected] and [email protected]

Contribution: Supervision, Validation, Funding acquisition, Writing - review & editing

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Yun Wu

Corresponding Author

Yun Wu

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China

Correspondence

Yun Wu and Ye Zhang, Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui Province, China.

Email: [email protected] and [email protected]

Contribution: Formal analysis, Funding acquisition, Supervision, Writing - review & editing

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First published: 26 March 2023
Citations: 2

Penglei Wang and Meixian Song contributed equally to this work.

Funding information: Clinical Trial Cultivation Program of the Second Affiliated Hospital of Anhui Medical University (grant number: 2021LCZD17)Clinical Research Funding of Hubei Chen Xiaoping Science and Technology Development Foundation (grant number: CXPJJH12000005-07-44).

Abstract

Aims

Thyroidectomy is frequently associated with substantial postoperative pain. Esketamine, an N-methyl-d-aspartate receptor antagonist, has been demonstrated to be effective in multiple analgesia scenarios. We hypothesized that intraoperative administration of esketamine may reduce perioperative opioid consumption and postoperative pain in patients undergoing thyroidectomy.

Methods

Sixty patients undergoing thyroidectomy were randomly assigned to two groups. Patients in the esketamine group received a pre-incisional intravenous bolus of esketamine (0.5 mg kg−1) followed by a continuous infusion of 0.24 mg kg−1 h−1 until the beginning of wound closure. Patients in the placebo group received 0.9% NaCl (bolus and infusion). The primary outcome was perioperative sufentanil consumption. The postoperative pain, sleep quality and adverse events during the first postoperative 24 h were also evaluated.

Results

Patients in the esketamine group consumed significantly less sufentanil than those in the saline group (24.6 ± 3.1 μg vs. 33.7 ± 5.1 μg, mean difference, 9.1; 95% confidence interval [CI], 6.9–11.3, P < .001). Postoperative pain scores were significantly lower in the esketamine group than those in the saline group during the first 24 h postoperatively (P < .05). Patients receiving esketamine experienced higher sleep quality than those in the saline group during surgical night (P = .043). There were no significant differences in adverse events between the two groups.

Conclusions

Intraoperative administration of esketamine reduces perioperative sufentanil consumption and postoperative pain without increasing psychotomimetic side effects in patients undergoing thyroidectomy. The development of combined anaesthesia regimens, including esketamine, may foster strategies for pain management during thyroidectomy.

CONFLICT OF INTEREST STATEMENT

The authors declare that they have no conflicts of interest.

DATA AVAILABILITY STATEMENT

Data are available by sending email to [email protected].