Effects of esketamine for postoperative analgesia on postoperative immune function and early-stage anxiety and depression in patients with cervical cancer
Objective To investigate the effects of esketamine on postoperative analgesia,immune function and early-stage postoperative anxiety and depression in patients undergoing laparoscopic radical cervical cancer surgery.Methods Sixty patients treated with elective laparoscopic radical cervical cancer surgery from December 2021 to October 2022 were included.They were randomly divided into the observation group and control group by computer random number table.Patients in the observation group were given intravenous 1mg/kg esketamine combined with 1μg/kg sufentanil for postoperative controlled analgesia,and those in the control group were given 2μg/kg sufentanil for postoperative controlled analgesia.The pain degree assessed by the Numerical Rating Scale(NRS)at 4h(T1),12h(T2),24h(T3)and 48h(T4)postoperatively,and the adverse events were compared between the two groups.Serum levels of interferon-gamma(IFN-γ),interleukin-4(IL-4)and the IFN-γ/IL-4 ratio were measured at 30min before induction,T3 and T4 by ELISA.The Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS)scores at 1d preoperatively and 3 d postoperatively were compared between groups.Results There was no significant difference in the NRS score at each time point between groups(P>0.05).The incidence of postoperative nausea and vomiting(PONV)in the observation group was significantly lower than that of the control group(P<0.05).Compared with those at T0,serum levels of IFN-γ and IFN-γ/IL-4 ratio significantly decreased at T3,and IL-4 significantly increased in the observation group(P<0.05).Moreover,serum IFN-γ level and IFN-γ/IL-4 ratio at T4 in the observation group were similar to the baseline levels(P>0.05).Serum levels of IFN-γ and the IFN-γ/IL-4 ratio at T3 and T4 in the observation group were significantly higher compared with those of the control group,while serum IL-4 at T3 was significantly lower(P<0.05).The SAS and SDS scores at 3d postoperatively in the observation group were significantly higher than those at 1d preoperatively(P<0.05).In the control group,only the SAS score at 3 d postoperatively was significantly higher than that at 1 d preoperatively(P<0.05).The SAS and SDS scores of the observation group at 3 d postoperatively were significantly lower than those of the control group(P<0.05).Conclusion Esketamine can effectively relieve postoperative pain,regulate the release of inflammatory factors,improve postoperative immune function and effectively alleviate early-stage postoperative anxiety and depression of patients with cervical cancer.
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