Cardiothoracic & vascular anesthesia
Intravenous Esketamine Versus Erector Spinae Plane Block for Postoperative Recovery Quality Following Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Non-Inferiority Trial
Authors' conclusion
Intravenous esketamine provides postoperative recovery quality that is non-inferior to ESPB after VATS, primarily because of its beneficial effects on mood, which compensates for its weaker early analgesia.
Study context
- Population
- Patients undergoing video-assisted thoracoscopic surgery (VATS), university hospital
- Participants
- 112 patients
- Comparison
- IV esketamine vs ESP block
- Primary endpoint
- Quality of recovery (QoR-15 score)
- Follow-up
- POD 1 and 2
Methodological detailsnon-inferiority, single-centre, sham-controlled
- Non-inferiority
- Single-centre
- Sham-controlled
Primary result
As reported in the abstract
QoR-15 score difference between groups · POD 1 and POD 2
Difference in QoR-15 between the groups, POD 1: mean difference
1.0
95% CI −2.9 to 4.8p = 0.622
Difference in QoR-15 between the groups, POD 2: mean difference
0.4
95% CI −3.4 to 4.3p = 0.833
Further findings
| Outcome | P value |
|---|---|
| Pain scores during coughing · 4 and 8 h postoperativelyESPB vs Esketamine · 4 h | P = 0.026 |
| Pain scores during coughing · 4 and 8 h postoperativelyESPB vs Esketamine · 8 h | P = 0.006 |
Pain scores during coughing · 4 and 8 h postoperatively
- Significantly lower pain scores in the ESPB group
Hospital Anxiety and Depression Scale (HADS) scores
- Lower HADS scores in the esketamine group
Safety
- Lower incidence of hypotension in the esketamine group
Original publication
Intravenous Esketamine Versus Erector Spinae Plane Block for Postoperative Recovery Quality Following Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Non-Inferiority Trial. J Cardiothorac Vasc Anesth. Published 3 January 2026. doi:10.
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