Effects of different doses of esketamine on postoperative pain and depression in patients with breast cancer
Objective To compare the effects of different doses of intravenous esketamine on postoperative-pain and depression in patients withbreast cancer.Methods 120 female patients who underwent radical surgery of breast cancer under selective general anesthesia in the hospital were selected and divided into control group,low-dose group and high-dose group by computer random number table,with 40 cases per group.All patients were induced with the same anesthetic,and after tracheal intubation,the control group was intravenously injected with 5 mL of 0.9％physiological saline,and intravenously pumped at a rate of 10 mL/h during surgery.The low-dose group received a dosage of 1.5 mg/kg of ketamine,diluted to 50 mL with 0.9％physiological saline,followed by intravenous injection of 5mL after tracheal intubation,followed by intravenous pumping at a rate of 5mL/h until the end of the surgery.In the high-dose group,ketamine was diluted to 50 mL with 0.9％physiological saline at a dosage of 2.5 mg/kg.5 mL was intra-venously injected after tracheal intubation,followed by intravenous infusion at a rate of 5 mL/h until the end of the surgery.The amount of opioid drugs used during and 24 and 48 hours after surgery were com-pared among 3 groups.Visual analog scale(VAS)scores at 4 hours,8 hours,24 hours,48 hours,1 month and 3 months after surgery were compared.The hamilton depression scale-17(HAMD-17)and Quality of Recovery 15(QOR-15)scores were evaluatedat1 week,1 month,and 3 months after the sur-gery.The incidence of adverse reaction were compared.Results The effective subjects in the control group,low-dose group,and high-dose group were 38,40 and 39 respectively.The dosage of sufentanil in the low-dose group during surgery and 24 hours after surgery was lower than that in the control group,while the dosage of sufentanil in the high-dose group during surgery,24 hours after the surgery and 48 hours after the surgery was lower than that in the control group and low-dose group(P＜0.05).The VAS scores of the high-dose group at 4 hours,8 hours,24 hours,48 hours,1 month and 3 months post-operatively were lower than those of the control group,while the VAS scores of the high-dose group at 4 hours,8 hours and 24 hours postoperatively were lower than those of the low-dose group(P＜0.05).The HAMD-17 scores of the high-dose group were lower than those of the control group at 1 week,1 month and 3 months after the surgery.The HAMD-17 scores of the low-dose group were lower than those of the control group at 1 week after surgery,while the HAMD-17 scores of the high-dose group were lower than those of the low-dose group at 1 month and 3 months after the surgery(P＜0.05).There was no significant difference in the incidence of adverse reactions within 48 hours and QOR-15 score at 1 week,1 month and 3 months after the operation between the 3 groups(P＞0.05).Conclusion Both low-dose and high-dose esketamine can alleviate postoperative pain and depression in breast cancer patients,while high-dose esketamine has more significant and lasting effect in inhibiting postoperative pain and depressiony.
万方数据
维普
