Esketamine for Postoperative Analgesia Improves Short-Term Postoperative Sleep Quality in Patients Undergoing Thoracoscopic Surgery: Study Protocol of a Single-Center, Prospective, Double-Blind Randomized Controlled Trial

Background Postoperative sleep disturbances (PSD) may contribute to postoperative delirium, cognitive dysfunction, exacerbation of acute postoperative pain, and delayed recovery. This randomized controlled trial aimed to investigate whether patient-controlled intravenous analgesia (PCIA) with esketamine enhances postoperative sleep quality and reduces clinical complications compared to sufentanil. Methods This single-center, prospective, double-blind, randomized controlled trial enrolled patients aged 18–65 years with ASA of Anesthesiologists physical status I-III, without severe comorbidities, and scheduled for unilateral lobectomy or segmentectomy under double-lumen endotracheal intubation. The sample size was 79 patients per group. Participants in the intervention group will receive esketamine-based PCIA, whereas those in the control group will receive sufentanil-based PCIA. The primary outcomes were Athens Insomnia Scale scores and incidence of PSD during the first three postoperative days. Secondary outcomes included resting and movement-induced pain scores, Hospital Anxiety and Depression Scale (HADS) scores, incidence of anxiety, depression, nausea, vomiting, dizziness, esketamine-related psychiatric adverse events, and patient satisfaction scores during the first three postoperative days. Discussion This study evaluated the effects of esketamine-based postoperative analgesia on improving short-term sleep quality in patients undergoing thoracoscopic surgery while investigating its impact on postoperative complications, including pain, nausea, vomiting, anxiety, and depression. These results might provide evidence for optimizing sleep quality in these patients and further explore the clinical applications of esketamine. Trial registration: The trial was registered before patient enrollment in the Chinese Clinical Trial Registry (registry no. ChiCTR2400088106, last updated on August 12, 2024).