Perioperative medicine & outcomes
Efficacy and safety of perioperative esketamine in improving postoperative sleep disturbances: A systematic review and meta-analysis
Authors' conclusion
Perioperative esketamine effectively reduces the incidence of early postoperative sleep disturbances and improves subjective sleep quality in adult surgical patients, with the timing of administration being the primary source of heterogeneity.
Study context
- Population
- Adult surgical patients
- Participants
- 1,956 patients · 14 randomized controlled trials (RCTs)
- Comparison
- Perioperative IV esketamine vs control
- Outcome
- Postoperative sleep disturbance scale score and incidence of postoperative sleep disturbances (PSD%)
- Follow-up
- First postoperative night
Methodological detailssubgroup analysis
- Subgroup analysis
Pooled result
As reported in the abstract
POD1
Esketamine vs ControlOdds ratio (95% CI)P value
PSD%
0.38(0.29–0.50)
P < 0.00001Esketamine vs ControlSMD (95% CI)P value
Subjective sleep quality; I2 = 88%
−0.63(−1.09 to −0.16)
P = 0.009Further pooled results
Postoperative sleep quality by administration mode (subgroup)
- Both single-dose and continuous intraoperative esketamine consistently improved postoperative sleep quality
Postoperative pain scores
- No statistically significant difference between esketamine and control
Postoperative rescue analgesia
- Significantly lower incidence in the esketamine group
Safety
Adverse events
- Only drowsiness markedly increased with esketamine; no significant differences for other adverse reactions
Original publication
Efficacy and safety of perioperative esketamine in improving postoperative sleep disturbances: A systematic review and meta-analysis. J Clin Anesth. Published 8 June 2026. doi:10.
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