Efficacy of Intravenous Administration of Esketamine in Preventing and Treating Rebound Pain After Thoracic Paravertebral Nerve Block: A Prospective Randomized, Double-Blind, Placebo-Controlled Trial

Xu Zeng,1,2 Xianjie Zhang,2 Wencai Jiang,2,&ast; Xinyu Zhou1,&ast; 1Department of Anaesthesiology, Chengdu Medical College, Chengdu, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital of Deyang City, Deyang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjie Zhang, Department of Anesthesiology, People’s Hospital of Deyang City, Deyang, People’s Republic of China, Email zxianjiemazui@163.comPurpose: Investigating the efficacy of intraoperative fractionated intravenous esketamine in the prevention of rebound pain after cessation of thoracic paravertebral nerve blockade.Methods: One hundred and twenty patients who underwent elective thoracoscopic lobectomy were selected for the study and were randomly divided into two groups, the esketamine group was given 0.5 mg/kg and 0.3 mg/kg of esketamine at the induction of anaesthesia and 30 minutes before the end of the operation, respectively, and the control group was given an equal amount of saline. The incidence of rebound pain (RP) 7 days after surgery and postoperative recovery were compared between the two groups.Results: The NRS pain scores at 24 and 48 hours postoperatively in the esketamine group were significantly lower than those in the control group (P < 0.05). The incidence of postoperative rebound pain was significantly lower in the esketamine group than in the control group (P < 0.05). The consumption of sufentanil was less in the esketamine group in the postoperative 48 hours (P < 0.05). Postoperative recovery was compared between the two groups and the difference was not statistically significant.Conclusion: Intravenous esketamine reduces postoperative pain scores, decreases the incidence of rebound pain after cessation of thoracic paravertebral block, and reduces opioid consumption.Keywords: esketamine, rebound pain, paravertebral nerve block, postoperative pain