{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:49:05Z","timestamp":1792676945400,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Esketamine may reduce acute postoperative pain in several settings. However, the effects of low\u2010dose esketamine on postoperative pain after vestibular schwannoma (VS) resection with propofol\/remifentanil total intravenous anaesthesia (TIVA) are unclear. The aim of this study is to observe the effects of intraoperative low\u2010dose esketamine on postoperative pain after vestibular schwannoma resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010centre, randomized, placebo\u2010controlled, double\u2010blind trial included 90 adults undergoing VS resection via the retrosigmoid approach with TIVA. The patients were randomly allocated to two groups: esketamine or control (n\u2009=\u200945 in each group). Patients received low\u2010dose esketamine (0.2 mg\/kg) or a similar volume of normal saline after dural closure. The primary outcome was the pain score during movement (gentle head movement) at 24 h postoperatively. Secondary outcomes included recovery time, bispectral index (BIS) values and haemodynamic profiles during the first 30 min after esketamine administration, and adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Low\u2010dose esketamine did not reduce pain scores at rest (<jats:italic>P<\/jats:italic> &gt; .05) or with movement (<jats:italic>P<\/jats:italic> &gt; .05) within the first 24 h after surgery. Esketamine moderately increased BIS values for at least 30 min after administration (<jats:italic>P<\/jats:italic> &lt; .0001) but did not affect heart rate (P\u2009=\u2009.992) or mean arterial blood pressure (<jats:italic>P<\/jats:italic>\u2009=\u2009.994). Esketamine prolonged extubation time (<jats:italic>P<\/jats:italic>\u2009=\u2009.042, 95% confidence interval: 0.08 to 4.42) and decreased the effect\u2010site concentration of remifentanil at extubation (<jats:italic>P<\/jats:italic>\u2009=\u2009.001, 95% confidence interval: \u22120.53 to \u22120.15) but did not affect the time to resumption of spatial orientation. Postoperative nausea and vomiting rates did not differ between groups, and no hallucinations or excessive sedation was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intraoperative low\u2010dose esketamine did not significantly reduce acute pain after VS resection with propofol\/remifentanil TIVA. However, BIS values increased for at least 30\u2009min after esketamine administration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16081","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T22:48:59Z","timestamp":1713998939000},"page":"1892-1899","source":"Crossref","is-referenced-by-count":8,"title":["Effects of intraoperative low\u2010dose esketamine on postoperative pain after vestibular schwannoma resection: A prospective randomized, double\u2010blind, placebo\u2010controlled study"],"prefix":"10.1111","volume":"90","author":[{"given":"Kaizheng","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Eye &amp; ENT Hospital Fudan University  Fenyang People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaming","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shanghai Sixth People's Hospital Jiaotong University  Shanghai 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