Different doses of Esketamine infusions (particularly 4 µg/kg/h) improved the quality of recovery 1 and 3 days after modified radical mastectomy and also decreased the intensity of postoperative pain.

The purpose of a randomized, double-blind, controlled study was to determine the influence of various Esketamine doses on postoperative quality of recovery in females undergoing modified radical mastectomy.

Overall, 99 female subjects were randomly divided into the control group (Group C: Received normal saline), the high-dose Esketamine group (Group E2: 0.5 mg/kg loading, 4 µg/kg/h infusion), and the low-dose Esketamine group (Group E1: 0.5 mg/kg loading, 2 µg/kg/h infusion). The quality of recovery-15 (QoR-15) ratings on postoperative day 1 (POD1) and day 3 (POD3) were the major endpoints ascertained.

The secondary outcomes were the POD1 sleep quality scores, the bispectral index values at 10, 30, and 60 minutes following surgery, the numeric rating scale (NRS) pain scores within 24 h post vomiting, sleepiness, surgery, intraoperative awareness, nausea, and nightmare.

On POD1 and POD3, group E1 and group E2 had higher total QoR-15 scores than group C. At 10, 30, and 60 minutes following surgery, group E1 and group E2 had greater POD1 and bispectral index scores for sleep quality than group C. The NRS pain scores in groups E1 and E2 at 2, 4, 6, 12 and 24 h after surgery were less than those in group C. In comparison to group E1, group E2 had reduced NRS pain scores at 6, 12, and 24 hours following surgery. In comparison to group C, group E1 and group E2 experienced more instances of sleepiness.

The various Esketamine infusion doses, specifically 4 µg/kg/h mitigated postoperative pain and also helped patients having modified radical mastectomy recover more quickly after surgery. However, Esketamine use raised the occurrence of drowsiness and bispectral index values.