Abstract: Objective To explore the effect of esketamine combined with transversus abdominis plane block （TAP） on intraoperative analgesia and postoperative quality of recovery among patients undergoing laparoscopic cholecystectomy （LC）. Methods A total of 96 patients at 40-75 years of age undergoing LC were randomly divided into three groups： esketamine group （group S, n=33）, TAP group （group T, n=31）, and esketamine + TAP group （group TS, n=32）. Patients in the group S and the group TS received 0.125 mg/kg esketamine immediately following the induction of anesthesia. Patients in the group T and the group TS received TAP block after induction of anesthesia. Observations included QoR-40 at postoperative 24 h, intraoperative opioid and propofol consumption, NRS score, and the incidence of post-operative nausea and vomiting （PONV） at postoperative 2 d. Results Compared with group S and group T, global QoR-40 scores and the dimensional scores of emotional state, pain, and physical independence were significantly higher in the group TS at postoperative 24 h, and the NRS score of the group TS was significantly lower than those in the group S and the group T at postoperative 4, 8, and 24 h （P<0.05）. The Ramsay score of the group TS was significantly lower than those in the group S and the group T at postoperative 0.5, 4, and 8 h （P<0.05）. Conclusion Small doses of ketamine in addition to TAP can improve the quality of recovery and reduce postoperative pain.

Key words: Esketamine, Transversus abdominis plane block, Quality of recovery