Effect of a Subanesthetic Dose of Esketamine on Postoperative Sleep Disturbance After Oocyte Retrieval Under Intravenous Anesthesia: A Randomized Controlled Trial

Purpose

Postoperative sleep disturbance (PSD) is a common complication after oocyte retrieval under intravenous anesthesia. This study aimed to evaluate whether a subanesthetic dose of esketamine reduces the incidence of PSD. Patients and Methods: This randomized, double-blind, placebo-controlled trial included 196 women undergoing oocyte retrieval under intravenous anesthesia. Participants were randomly assigned to the esketamine or control group. During anesthesia induction, the esketamine group received an intravenous bolus of esketamine 0.2 mg/kg, whereas the control group received an equivalent volume of normal saline. The primary analysis was conducted according to the intention-to-treat principle, with missing outcome data handled using multiple imputation; 189 participants (95 in the control group and 94 in the esketamine group) were included in the per-protocol sensitivity analysis. The primary outcome was the incidence of PSD on postoperative day (POD) 3, defined using a composite criterion of an Athens Insomnia Scale (AIS) score ≥ 6 or a numerical rating scale (NRS) score ≥ 6. Secondary outcomes included the incidence of PSD on POD 1, postoperative pain scores, postoperative anxiety and depression scores, and patient satisfaction with the anesthetic technique.