Effect of esketamine on the quality of postoperative recovery and inflammatory stress in patients undergoing thoracoscopic radical lung cancer treatment
Objective:To observe the effect of esketamine on the quality of postoperative recovery and inflammatory stress in patients undergoing radical thoracoscopic lung cancer treatment.Methods:Sixty patients who underwent thoracoscopic radical lung cancer surgery in Suzhou Hospital of Nanjing Medical University from September 2022 to May 2023 were selected,and were divided into the esketamine group(Group S)and the control group(Group C)using the randomized numerical table method,with 30 cases in each group.The anesthesia induction protocol was the same in both groups,and group S was injected with esketamine 0.25 mg/kg intravenously and continuously pumped intravenously to the suture skin at 0.15 mg/(kg·h).Group C was given the same dosage of saline after the induction of anesthesia and during the operation.The anesthesia time,operation time,extubation time,and postanesthesia care unit(PACU)stay time,the 40-item Quality of Recovery Questionnaire(QoR-40)scores at each time point of 24 h preoperatively(T0),24 h postoperatively(T1),and 48 h postoperatively(T2)were recorded in the two groups,and the expression levels of TNF-α and IL-6 were detected by ELISA at the T0 and T2,and the incidence of complications such as delirium,nausea and vomiting,nightmare and dizziness were recorded for the patients in the two groups within 24 h.Results:There was no statistically significant difference in operation time,extubation time and PACU stay time between the two groups(P>0.05).Intraoperative remifentanil consumption was significantly lower(P<0.05)and postoperative sufentanil consumption was significantly lower(P<0.05)in patients of group S compared with group C.The number of analgesic pump presses was significantly lower in group S than in group C during the postoperative period of 48 h(P<0.05).The preoper-ative total QoR-40 scores and various dimension scores of patients in the two groups were compared,and the differences were not statistically significant(P>0.05).Compared with T1 period,the total QoR-40 scores as well as the scores of all dimen-sions of the patients in the two groups decreased significantly at T1 and T2 postoperatively,and the difference was statistically significant(P<0.05).Compared with the group C,the total QoR-40 score,physical comfort,psychological support and pain perception scores of the group S were significantly higher at T1,and the difference was statistically significant(P<0.05);the total QoR-40 score,physical comfort and pain perception scores of the group S were significantly higher than those of the group C at T2,and the difference was statistically significant(P<0.05).At T0,there was no statistically significant difference between the serum TNF-α and IL-6 levels of the two groups(P>0.05).At T2,serum IL-6 and TNF-α levels were significantly higher in both groups(P<0.05),but were lower in the group S than in the group C(P<0.05).There was no difference in the comparison of the incidence of postoperative adverse reactions between the two groups(P>0.05).Conclusion:Eslicarbazone can improve the quality of postoperative recovery in patients undergoing radical thoracoscopic lung cancer treatment,reduce post-operative inflammatory reactions,regulate the immune balance of patients,and contribute to accelerating the rapid recovery of patients in the postoperative period.
lung canceresketaminequality of postoperative recoverythoracoscopyinflammatory stress response
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