This interventional trial (n=400) investigates the effect of esketamine infusion during laparoscopic sleeve gastrectomy on postoperative depressive symptoms among obese patients.
Randomised, double-blind, parallel-group trial comparing a standardized non-opioid anaesthesia strategy using intraoperative esketamine infusion versus standard opioid-based general anaesthesia in obese patients undergoing laparoscopic sleeve gastrectomy.
Primary objective is to evaluate postoperative depressive symptoms (HAMD) after esketamine-based anaesthesia; secondary outcomes include perioperative analgesia, opioid-related complications, and safety/tolerability.
Intervention arm receives loading esketamine 0.25 mg/kg with continuous intraoperative infusion (~0.25 mg/kg/h) plus dexmedetomidine; control arm receives induction sufentanil and remifentanil infusion with standard maintenance agents.
Standardised non-opioid anaesthesia with intraoperative esketamine infusion and dexmedetomidine.
Loading 0.25 mg/kg with continuous infusion ~0.25 mg/kg/h; coadministered dexmedetomidine 0.5 μg/kg; propofol and rocuronium for induction/airway management.
Standard opioid-based general anaesthesia including remifentanil and sufentanil.
Induction sufentanil 0.5 μg/kg; remifentanil infusion 5–15 μg/kg/h; maintenance with propofol, sevoflurane and dexmedetomidine as per protocol.