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已发表论文
单剂量硬膜外艾司氯胺酮与氢吗啡酮用于胸部和上腹部手术的比较有效性：一项随机试验
Authors Song Y, Wang C, Huang N, He H , Hong W, Wu J, Yao M, Miao C, Liang C
Received 10 November 2025
Accepted for publication 29 January 2026
Published 3 February 2026 Volume 2026:20 580521
DOI https://doi.org/10.2147/DDDT.S580521
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Yuejiao Song,1,* Chengyu Wang,2,* Ning Huang,2,* Huangwei He,1 Weifeng Hong,1 Junmei Wu,1 Minmin Yao,2 Changhong Miao,2 Chao Liang1,2
1Department of Anesthesiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People’s Republic of China; 2Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chao Liang, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email superwm226@126.com Changhong Miao, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email miao.changhong@zs-hospital.sh.cn
Purpose: This study aimed to evaluate the effectiveness of a single epidural dose of esketamine versus hydromorphone in patients undergoing abdominal and thoracic surgeries.
Patients and Methods: Patients undergoing elective abdominal and thoracic surgery were randomly assigned to receive either a single epidural injection of 15 mg esketamine (Group E) or 0.5 mg hydromorphone (Group H) at the end of surgery. All patients received intravenous patient-controlled analgesia postoperatively. The primary outcome was hydromorphone consumption within 48 hours after surgery. Secondary outcomes included time to first rescue analgesia, hydromorphone consumption within 0– 24, 24– 48, and 48– 72 hours, numerical rating scale (NRS) pain scores, postoperative recovery scores, and complications.
Results: In total, 205 patients were enrolled, with 186 randomly assigned to either group E (n = 93) or group H (n = 93). Hydromorphone consumption within 48 hours postoperatively was significantly higher in group E than in group H. The time to first rescue analgesia was significantly longer in group H compared to group E. Within the first 24 hours postoperatively, patients in group E required more hydromorphone than those in group H. No significant difference in hydromorphone consumption between the two groups at 24– 48 and 48– 72 hours postoperatively. The NRS scores during movement were significantly higher in group E than in group H at 3 and 6 hours postoperatively.
Conclusion: Single-dose epidural esketamine for postoperative analgesia resulted in higher hydromorphone consumption and a shorter time to first rescue analgesia compared to hydromorphone.
Keywords: esketamine, epidural anesthesia, postoperative analgesia, hydromorphone
1Department of Anesthesiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, People’s Republic of China; 2Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chao Liang, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email superwm226@126.com Changhong Miao, Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China, Tel/Fax +86-021-64041990, Email miao.changhong@zs-hospital.sh.cn
Purpose: This study aimed to evaluate the effectiveness of a single epidural dose of esketamine versus hydromorphone in patients undergoing abdominal and thoracic surgeries.
Patients and Methods: Patients undergoing elective abdominal and thoracic surgery were randomly assigned to receive either a single epidural injection of 15 mg esketamine (Group E) or 0.5 mg hydromorphone (Group H) at the end of surgery. All patients received intravenous patient-controlled analgesia postoperatively. The primary outcome was hydromorphone consumption within 48 hours after surgery. Secondary outcomes included time to first rescue analgesia, hydromorphone consumption within 0– 24, 24– 48, and 48– 72 hours, numerical rating scale (NRS) pain scores, postoperative recovery scores, and complications.
Results: In total, 205 patients were enrolled, with 186 randomly assigned to either group E (n = 93) or group H (n = 93). Hydromorphone consumption within 48 hours postoperatively was significantly higher in group E than in group H. The time to first rescue analgesia was significantly longer in group H compared to group E. Within the first 24 hours postoperatively, patients in group E required more hydromorphone than those in group H. No significant difference in hydromorphone consumption between the two groups at 24– 48 and 48– 72 hours postoperatively. The NRS scores during movement were significantly higher in group E than in group H at 3 and 6 hours postoperatively.
Conclusion: Single-dose epidural esketamine for postoperative analgesia resulted in higher hydromorphone consumption and a shorter time to first rescue analgesia compared to hydromorphone.
Keywords: esketamine, epidural anesthesia, postoperative analgesia, hydromorphone