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已发表论文
艾司氯胺酮为基础的无阿片麻醉与阿片麻醉用于腹腔镜经腹腹膜前修补术后恢复质量的比较：一项随机非劣效性试验
Authors Liu H , Xing X, Jiang F, Zhang L, Chen L
Received 28 October 2025
Accepted for publication 15 January 2026
Published 27 January 2026 Volume 2026:20 572431
DOI https://doi.org/10.2147/DDDT.S572431
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Huan Liu, Xinyi Xing, Fan Jiang, Lei Zhang, Lijian Chen
Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
Correspondence: Lijian Chen, Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, People’s Republic of China, Email chenlijian77@ahmu.edu.cn
Purpose: This study aimed to compare the quality of postoperative recovery between esketamine-based opioid-free anesthesia (OFA) and opioid-based anesthesia (OBA) in patients undergoing laparoscopic transabdominal preperitoneal (TAPP) repair.
Patients and Methods: In this prospective, randomized, double-blind, noninferiority trial, 126 adults scheduled for elective laparoscopic TAPP repair were randomized to OFA (n = 63) or OBA (n = 63) group. The OFA group received esketamine (0.5 mg·kg− 1 induction, 0.4– 0.5 mg·kg− 1·h− 1 maintenance), while the OBA group received sufentanil (0.4 μg·kg− 1 induction) and remifentanil (0.1– 0.2 μg·kg− 1·min− 1 maintenance). The primary outcome was the 15-item Quality of Recovery (QoR-15) score at 24 hours postoperatively, with a noninferiority margin of − 8. Secondary outcomes included pain scores, rescue analgesia, sleep quality, safety outcomes.
Results: The OFA group showed a higher QoR-15 score at 24 hours postoperatively than the OBA group (median difference: 2; median [IQR]: 129 [125 to 132] vs 127 [123 to 130]; 95% CI, 0 to 4; P=0.014). Pruritus incidence was lower (P=0.027), vasopressor use was reduced (P = 0.012), and hypotensive episodes tended to be fewer (P=0.106) in the OFA group. Pain scores on coughing at 24 and 48 hours postoperatively were also lower in the OFA group (P=0.002 and P< 0.001, respectively).
Conclusion: Esketamine-based OFA provided a noninferior quality of postoperative recovery compared with OBA in patients undergoing laparoscopic TAPP repair, offering a safer alternative to OFA regimens that minimizes opioid-related complications while maintaining perioperative comfort and supporting enhanced recovery.
Keywords: esketamine, transabdominal preperitoneal, noninferiority trial, opioid-free anesthesia, postoperative recovery
Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
Correspondence: Lijian Chen, Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, People’s Republic of China, Email chenlijian77@ahmu.edu.cn
Purpose: This study aimed to compare the quality of postoperative recovery between esketamine-based opioid-free anesthesia (OFA) and opioid-based anesthesia (OBA) in patients undergoing laparoscopic transabdominal preperitoneal (TAPP) repair.
Patients and Methods: In this prospective, randomized, double-blind, noninferiority trial, 126 adults scheduled for elective laparoscopic TAPP repair were randomized to OFA (n = 63) or OBA (n = 63) group. The OFA group received esketamine (0.5 mg·kg− 1 induction, 0.4– 0.5 mg·kg− 1·h− 1 maintenance), while the OBA group received sufentanil (0.4 μg·kg− 1 induction) and remifentanil (0.1– 0.2 μg·kg− 1·min− 1 maintenance). The primary outcome was the 15-item Quality of Recovery (QoR-15) score at 24 hours postoperatively, with a noninferiority margin of − 8. Secondary outcomes included pain scores, rescue analgesia, sleep quality, safety outcomes.
Results: The OFA group showed a higher QoR-15 score at 24 hours postoperatively than the OBA group (median difference: 2; median [IQR]: 129 [125 to 132] vs 127 [123 to 130]; 95% CI, 0 to 4; P=0.014). Pruritus incidence was lower (P=0.027), vasopressor use was reduced (P = 0.012), and hypotensive episodes tended to be fewer (P=0.106) in the OFA group. Pain scores on coughing at 24 and 48 hours postoperatively were also lower in the OFA group (P=0.002 and P< 0.001, respectively).
Conclusion: Esketamine-based OFA provided a noninferior quality of postoperative recovery compared with OBA in patients undergoing laparoscopic TAPP repair, offering a safer alternative to OFA regimens that minimizes opioid-related complications while maintaining perioperative comfort and supporting enhanced recovery.
Keywords: esketamine, transabdominal preperitoneal, noninferiority trial, opioid-free anesthesia, postoperative recovery