• Ting Yang, Muhammad Saqib Mudabbar, Mingxing Xu, Qingmei Xiang, Bin Liu, and Qiang Fu.
• Department of Anesthesiology, The Third People's Hospital of Chengdu Affiliated to Southwest Jiaotong University, Chengdu, Sichuan, China.
• Medicine (Baltimore). 2023 Dec 22; 102 (51): e36754e36754.

BackgroundThe prevalence of obesity is high. Bariatric surgery is an effective treatment for severe obesity; however, the induction phase of anesthesia in these patients poses a risk of hypotension. Esketamine, known for its sympathetic nervous system stimulation, may stabilize blood pressure during induction. This study aimed to investigate the effects of esketamine on blood pressure in bariatric surgery patients.MethodsThis randomized controlled trial included 145 patients undergoing bariatric surgery. Patients were randomly assigned to receive esketamine or a control intervention during induction. Blood pressure and other vital signs were measured and compared between the 2 groups using statistical analyses.ResultsAdministration of esketamine increased blood pressure before intubation (T2). The incidence of hypotension was lower in the esketamine group at multiple time points during induction. Postoperatively, the esketamine group exhibited lower pain scores at 24 hours and a reduced need for rescue analgesics.ConclusionA single dose of 0.2 mg/kg esketamine during the induction phase of bariatric surgery can improve blood pressure stability and decrease the incidence of hypotension. Furthermore, it is associated with reduced postoperative pain. Future studies could explore the effects of higher esketamine doses and validate these findings in a larger and more diverse patient population.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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