Effects of esketamine combined with ultrasound-guided pectoral nerve block on postoperative analgesia, fatigue and immune function in patients with breast cancer
10.3760/cma.j.cn115807-20241028-00329
- VernacularTitle:艾司氯胺酮联合超声引导下胸神经阻滞对乳腺癌患者术后镇痛、疲劳及免疫功能的影响
- Author:
Yan WANG
1
;
Shiduo LI
1
;
Hongwei TONG
1
Author Information
1. 延安市人民医院手术麻醉科，延安 716000
- Publication Type:Journal Article
- Keywords:
Esketamine;
Pectoral nerve block;
Breast cancer;
Pain;
Fatigue;
Immune function
- From:
Chinese Journal of Endocrine Surgery
2025;19(2):222-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of esketamine combined with ultrasound-guided pectoral nerve block (PECS) on postoperative analgesia, fatigue and immune function in patients with breast cancer.Methods:A total of 80 female patients who underwent selective radical mastectomy in the Department of Anesthesiology, Yan’an People’s Hospital from Jan. 2019 to Jan. 2024 were chosen and separated into the observation group (n=40, esketamine + PECS) and the control group ( n=40, PECS) by random number table method. The analgesic effect [visual analogue scale (VAS) ], degree of sedation (Ramsay score) , immune function (CD3+, CD4+, CD8+) , fatigue [cancer fatigue scale (CFS) ] and cognitive function [mini mental state evaluation (MMSE) ] of the two groups were compared at different times. Results:VAS scores between two groups, at different time points and interaction had statistically significant differences ( Finter-group, time, interaction=0.52, 43.65, 0.83, P<0.05) ; Ramsay score between groups at different time points showed statistically significant differences ( Ftime=1.77, P<0.05) , but the comparison between groups and interaction did not ( Finter-group, interaction=0.47, 0.03, P>0.05) ; There were statistically significant differences in the intergroup, time point and interaction of CD3+ and CD4+ between the two groups, and in the time point and interaction of CD8+ ( Finter-group, time, interaction=33.35, 6.49, 12.76, 22.55, 8.37, 7.25, Ftime, interaction=6.94, 3.74, P<0.05) , while no statistically significant differences in the intergroup of CD8+ ( Finter-group = 0.48, P>0.05) ; At 12h (T 3) after surgery, the observation group had significantly lower CFS scores than before surgery (T 0) and the other group ( t=4.34、2.71、3.51、3.43、3.59、5.66, P<0.05) ; The comparison of MMSE scores between groups, at different time points and interaction showed statistically significant differences ( Finter-group, time, interaction = 42.86, 27.37, 19.85, P<0.05) . Conclusion:Esketamine combined with PECS has a good effect in breast cancer patients, which can reduce postoperative pain and fatigue, and has less effect on postoperative cognitive function.
