Esketamine vs. sufentanil for quality of recovery after outpatient gynecological surgery: a randomized clinical trial.

TL;DR

In a randomized trial of 125 outpatient gynecological surgery patients, esketamine and sufentanil combined with propofol showed no significant difference in quality of recovery scores on postoperative day 1 (137.9 vs 137.8).

Key findings

• No difference in QoR-15 scores on POD1 between esketamine (0.2 mg/kg) and sufentanil (0.1 μg/kg) groups
• Esketamine group had longer PACU stay (28 vs 23 min) and lower severe injection pain incidence (22.6% vs 50.8%)
• Esketamine group experienced higher postoperative pain at 30 minutes (30.6% vs 6.3%) and greater fatigue scores (3.0 vs 2.0)
• Other outcomes including nausea, vomiting, satisfaction, sleep quality, and anxiety/depression showed no significant differences

Why this matters at the bedside

Findings suggest esketamine does not provide early QoR advantage over sufentanil for outpatient gynecological procedures under sedation, despite some favorable secondary outcomes regarding injection pain.