After laparoscopic colorectal surgery, a single esketamine dose was linked to faster bowel recovery

The edition in brief

In a single-centre randomised trial of 104 adults having elective laparoscopic colorectal cancer surgery, a subanaesthetic dose of intravenous esketamine (0.2 mg/kg) given 30 minutes before the end of surgery shortened median time to first flatus from 60 to 52 hours and first defecation from 95 to 87 hours, with lower gastrointestinal intolerance scores, less nausea and distension, and better early sleep. Length of stay and costs did not change. A Gastroenterology review updating the global burden of liver disease estimates that chronic liver disease affects more than 1.5 billion people, and that cirrhosis and primary liver cancer cause nearly 2.4 million deaths a year, with alcohol-related and metabolic liver disease rising and viral hepatitis gaps persisting. In an 84-patient randomised trial in IBS, 90 days of zinc, with or without a probiotic, raised serum zinc and lowered oxidative stress markers but did not improve sleep quality; symptoms were not the outcome. The pearl covers six-monthly liver cancer surveillance in cirrhosis.