Effect of low-opioid anesthesia on postoperative mood in patients undergoing thoracoscopic surgery
10.3760/cma.j.cn131073-20240903-00506
- VernacularTitle:低阿片药麻醉对胸腔镜手术患者术后情绪的影响
- Author:
Jiayi ZHANG
1
;
Zhongneng XU
;
Wei FAN
;
Guangming LI
Author Information
1. 南京医科大学附属淮安第一医院麻醉科，淮安 223300
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Anesthesia, general;
Analgesics, opioid;
Depression;
Anxiety;
Thoracoscopy;
Esketamine
- From:
Chinese Journal of Anesthesiology
2025;45(5):553-558
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of low-opioid anesthesia based on combination of esketamine and dexmedetomidine on the postoperative mood in patients undergoing thoracoscopic surgery.Methods:In this randomized controlled trial, 130 American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients of either sex, aged 18-65 yr, with body mass index ≤30 kg/m 2, undergoing elective video-assisted thoracoscopic surgery, were divided into 2 groups using a random number table method: low-opioid anesthesia group and conventional opioid anesthesia group, with 65 patients in each group. The patients in two groups received either a low-opioid anesthesia based on combination of esketamine and dexmedetomidine or a sufentanil-based opioid anesthesia. Depression and anxiety were assessed using the Self-Rating Depression Scale and Self-Rating Anxiety Scale on day 1 before surgery and days 1, 3 and 7 after surgery. The intraoperative consumption of opioid, usage of vasoactive drugs, extubation time, duration of stay in the post-anesthesia care unit, Riker Sedation-Agitation Scale score after extubation, consumption of sufentanil within 24 h postoperatively, and pain score at 24 h postoperatively were recorded, and the occurrence of adverse reactions within 24 h postoperatively was also recorded. Results:Compared with conventional opioid anesthesia group, the postoperative Self-Rating Depression Scale score and incidence of depression were significantly decreased, the Self-Rating Anxiety Scale score and incidence of anxiety were decreased, the intraoperative consumption of opioid was reduced, the usage rate of metaraminol was decreased, the usage rate of nicardipine was increased, the duration of stay in the post-anesthesia care unit was shortened, the Riker Sedation-Agitation Scale score was decreased after tracheal extubation, the consumption of sufentanil was reduced after operation, the pain score was decreased, and the incidence of postoperative nausea and vomiting and dizziness was decreased in low-opioid anesthesia group ( P<0.05). Conclusions:The low-opioid anesthesia based on combination of esketamine and dexmedetomidine can relieve the postoperative depression and anxiety and improve the quality of postoperative recovery when used in patients undergoing thoracoscopic surgery.
