Evaluation of low-dose esketamine on sleep quality in elderly patients undergoing painless gastroscopy

Purpose: To investigate the effect of low-dose esketamine on sleep quality in elderly patients undergoing painless gastroscopy.Methods: A total of 84 patients (ASA grade II -III, > 65 years old) who were to undergo painless gastroscopy in Guanggu District, Wuhan Third Hospital from June to July 2021 were enrolled. The diagnosis of sleep disorder was performed using Pittsburgh Sleep Quality Index (PSQI) before surgery. Patients with PSQI >= 5 were diagnosed with a sleep disorder (group E, n = 42), while those with PSQI < 5 were normal (group C, n = 42). Patients in both groups were given a single intravenous injection of esketamine 0.2 mg/kg 3 min before anesthesia induction, followed by an intravenous loading dose of propofol 1.5 mg/kg. Maintenance of anesthesia was achieved by intravenous pumping with propofol at 4 mg/kg per hour.Results: Sleep quality of patients in both groups improved after surgery, but the PSQI scores decreased more than that of group E (p < 0.05), especially on the night after surgery. Compared with group C, anesthesia induction time was longer and the number of propofol supplementation was increased in group E (p < 0.05). Groups C and E manifested no significant differences in postoperative satisfaction and occurrence of adverse reactions (p > 0.05).Conclusion: Low-dose esketamine improves the sleep quality of elderly patients with painless gastroscopy without increasing the risk of circulating breathing during surgery. However, multi-center large-scale studies will be required in further investigations in order to validate the findings of this study.