What question did this study set out to answer?

This trial aims to compare the efficacy of esketamine and magnesium sulfate in reducing negative emotions and pain after endoscopic sinus surgery.

May 9, 2026Open Access

Effects of Intravenous Esketamine or Magnesium Sulfate on Early Postoperative Negative Emotions and Pain in Patients Undergoing Endoscopic Sinus Surgery: A Randomized Controlled Trial

Key Points

This trial aims to compare the efficacy of esketamine and magnesium sulfate in reducing negative emotions and pain after endoscopic sinus surgery.
137 patients undergoing endoscopic sinus surgery were randomly assigned to receive esketamine, magnesium sulfate, or saline control.
Esketamine and magnesium sulfate were administered intravenously preoperatively with specific dosages until surgery end.
Postoperative emotional and pain assessments were conducted using HADS, SAS/SDS, and VAS scores at specified intervals.
On postoperative day 1, emotional scores were significantly lower in both esketamine and magnesium sulfate groups compared to control (P < 0.05).
On postoperative day 2, emotional scores in the esketamine group were lower than in both control and magnesium groups (P < 0.05).
VAS pain scores were significantly reduced in both treatment groups at multiple postoperative time points (P < 0.001).

Abstract

Background: N-methyl-D-aspartate (NMDA) receptor antagonists are crucial for managing perioperative pain and psychological distress. Both esketamine and magnesium sulfate are NMDA receptor antagonists. This study compared their effects on early postoperative negative emotions and pain in patients undergoing endoscopic sinus surgery (ESS). Methods: This study involved 137 patients scheduled for ESS were randomly assigned to three groups: Group E (esketamine), Group M (magnesium sulfate), and Group C (saline control). Before induction, Group E received esketamine 0.25 mg/kg loading over 10 min then 0.25 mg/(kg·h) infusion until surgery end; Group M received magnesium sulfate 30 mg/kg loading over 10 min then 10 mg/(kg·h) infusion until surgery end; Group C received equal volume of normal saline. Hospital Anxiety and Depression Scale (HADS) and Self-rating Anxiety/Depression Scale (SAS/SDS) scores were assessed on postoperative days 1 and 2 (POD1, POD2). VAS scores, hemodynamics, intraoperative drug use, and adverse events were also evaluated. Results: On POD1, HADS, SAS, and SDS scores were significantly lower in Groups E and M than in Group C ( P < 0.05). On POD2, these scores were lower in Group E than in Groups C and M( P < 0.05). VAS pain scores were significantly lower in Groups E and M at 2, 4, and 8 hours postoperatively ( P < 0.001). Remifentanil consumption was lower in Groups E and M than in Group C ( P < 0.05), nitroglycerin consumption was lower in Group M than in Group E ( P < 0.05). Incidences of sore throat, rescue analgesia, postoperative respiratory depression, and PONV in Groups E and M were significantly lower than those in Group C ( P < 0.05). Conclusion: Intravenous esketamine or magnesium sulfate effectively alleviated negative emotions and pain on POD1 in patients undergoing ESS.Esketamine demonstrated superior efficacy over magnesium sulfate on POD2. Keywords: esketamine, magnesium sulfate, anxiety, depression, postoperative pain, endoscopic sinus surgery

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Cite This Study

Wang et al. (Fri,) studied this question.

synapsesocial.com/papers/69fececcb9154b0b828760f8 https://doi.org/https://doi.org/10.2147/tcrm.s588126

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