Effects of the subanesthetic dose of esketamine on postoperative sleep quality in patients undergoing modified radical mastectomy: a randomized, double-blind controlled trial
Bibliographic record
Abstract
Background Breast cancer is the most common malignant tumor among women worldwide. Surgical intervention is a critical component of treatment, yet the associated stress and anxiety can significantly disrupt postoperative sleep quality. Emerging evidences suggest that esketamine may offer benefits in alleviating emotional distress and enhancing sleep. The purpose of this study was to observe the effects of intraoperative subanesthetic dose of esketamine on the sleep of patients undergoing modified radical mastectomy. Methods This randomized, double-blind, controlled trial enrolled 145 female patients, who were randomly assigned to either the esketamine group (Group E, n = 72) or the control group (Group C, n = 73). Patients in Group E received esketamine (0.2 mg/kg loading dose, followed by 0.1 mg/kg/h infusion), while those in Group C received saline (0.2 mL/kg loading dose, followed by 0.1 mL/kg/h infusion). The primary outcome was the total score on the Richards-Campbell Sleep Questionnaire (RCSQ) measured on postoperative day (POD) 1. Secondary outcomes included recovery time, the incidence of postoperative adverse events and rescue analgesia, Visual Analogue Scale (VAS) pain scores, short-form McGill’s Pain Questionnaire (SF-MPQ) sensory and affective scores, and Pittsburgh Sleep Quality Index (PSQI) scores. Results No significant differences were observed in the total RCSQ scores on POD 1 between Group E and Group C (median [interquartile range]: 46 [32–68] vs. 54 [40–71], p > 0.05). Recovery time was significantly longer in Group E compared to Group C (8 [5–11] vs. 6 [4–11] minutes; p = 0.02). There were no significant differences in the incidence of adverse events or remedial analgesia within 48 h postoperatively. Furthermore, no significant differences were observed between the groups in pain VAS scores, and SF-MPQ sensory or affective scores at 4, 24, and 48 h postoperatively. PSQI scores on POD 30 were not significantly different between the groups (p > 0.05). Conclusion For female patients without pre-existing sleep disorders undergoing modified radical mastectomy, intraoperative subanesthetic esketamine may not significantly impact postoperative sleep quality but potentially contribute to a prolonged recovery time. Trial registration This trial was registered at the Chinese Clinical Trial Registry on July 03, 2022 ( https://www.chictr.org.cn ; Registration number: ChiCTR2200061818).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".