Effects of low-dose esketamine on postoperative pain and depression degree in colorectal cancer patients undergoing radical surgery
10.3760/cma.j.cn115355-20240520-00247
- VernacularTitle:低剂量艾司氯胺酮对结直肠癌根治术患者术后疼痛及抑郁程度的影响
- Author:
Xiaolu FENG
1
;
Junfeng XI
1
;
Yue CAI
1
;
Li ZHAO
1
Author Information
1. 山西省肿瘤医院 中国医学科学院肿瘤医院山西医院 山西医科大学附属肿瘤医院麻醉科，太原 030013
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Anesthesia;
Esketamine;
Pain, postoperative;
Sedation;
Depression
- From:
Cancer Research and Clinic
2024;36(12):928-932
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of low-dose esketamine on postoperative pain and depression degree in patients undergoing radical surgery for colorectal cancer.Methods:A prospective randomized controlled study was conducted. Eighty-four patients who plan to undergo elective radical resection for colorectal cancer at Shanxi Province Cancer Hospital from December 2023 to March 2024 were divided into esketamine group (observation group) and 0.9% NaCl solution group (control group) using the random number table method, with 42 patients in each group. The observation group was given intravenous infusion of 0.25 mg/kg esketamine 30 minutes before anesthesia induction and 30 minutes before the end of surgery, while the control group was given intravenous infusion of the equal dose of 0.9% NaCl solution. The remaining anesthesia methods were the same for both groups. The postoperative pain number rating scale (NRS) scores, Ramsay sedation score and perioperative dosages of sufentanil, remifentanil and propofol were compared between the two groups. The Hamilton depression rating scale (HAMD) score was used to evaluate the degree of depression before and after surgery in two groups of patients and the score was compared between the two groups.Results:Two cases were discharged from the observation group and two cases were discharged from the control group due to postoperative catheterization and return to the intensive care unit. There were no statistically significant differences in gender, age, body mass index, anesthesia time, recovery time, extubation time, intraoperative fluid replacement volume, and fluid output between the two groups of patients (all P > 0.05). The dosage of remifentanil in the observation group was lower than that in the control group [(481±117) mg vs. (718±161) mg], and the difference was statistically significant ( t = 7.52, P < 0.001). The NRS scores of the observation group were lower than those of the control group at 1 and 2 hours after surgery, and the differences were statistically significant (both P < 0.001). The perioperative salvage analgesia rate in the observation group was lower than that in the control group [12.5% (5/40) vs. 32.5% (13/40)], and the difference was statistically significant ( χ2 = 4.59, P = 0.032). The Ramsay sedation scores of the observation group were higher than those of the control group at 1, 2, and 4 hours after surgery, and the differences were statistically significant (all P < 0.001). The HAMD scores of the observation group at 3 and 7 days after surgery were lower than those before surgery, and both were lower than those of the control group, and the differences were statistically significant (all P < 0.05). Conclusions:Low-dose esketamine used in radical surgery for colorectal cancer can not only effectively reduce perioperative pain and improve sedative effects, but also alleviate patients' depression and improve the quality and speed of postoperative recovery.
