Effects of esketamine on anxiety,depression and cognitive function in elderly patients with lung cancer after thoracoscopic lobectomy
Objective To evaluate the effects of esketamine on anxiety,depression and cognitive function in elderly patients with lung cancer after thoracoscopic lobectomy.Methods 80 elderly patients with lung cancer undergoing elective thoracoscopic lobectomy were randomly divided into an experimental group and a control group,with 40 cases in each group.General anesthesia was administered in both groups.The experimental group was given 0.2 mg/kg of esketamine intravenously at the time of induction of anaesthesia.Equal amounts of saline were administered to the control group.Post-operative analgesia with patient-controlled intravenous analgesia(PCIA):in the experimental group,1.2 μg/kg of sufentanil,0.3 mg/kg of esketamine and 10 mg of tropisetron;in the control group,1.2 μg/kg of sufentanil and 10 mg of tropisetron.Both groups were compared in terms of visual analogue scale(VAS)scores at 6 h postoperatively(T1),12 h postoperatively(T2),24 h postoperatively(T3)and 48 h postoperatively(T4)in resting and active state,mini-mental state examination(MMSE)score and incidence of postoperative delirium(POD)preoperatively(D0),postoperative day 1(D1)and postoperative day 3(D3),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores and incidence of depression at D0,D1 and D3,and incidence of postoperative adverse reactions.Results In resting and active state,VAS scores at T2 and T3 in the experimental group were lower than those in the control group(P<0.05).Compared with D0,MMSE scores of both groups were significantly decreased on D1(P<0.05).On D1,MMSE score of(26.35±0.98)points in the experimental group was significantly higher than(25.73±0.85)points in the control group(P<0.05).On D0-D3 postoperatively,POD occurred in 11 cases(27.5%)in the control group and 4 cases(10.0%)in the experimental group.The total incidence of POD in the experimental group was lower than that in the control group(P<0.05).On D1 and D3,SAS and SDS scores in both groups decreased compared with those on D0 in this group;the SAS scores in the experimental group were(38.93±3.79)and(37.85±3.54)points,which were lower than(41.88±3.02)and(39.68±3.56)points in the control group;SDS scores in the experimental group were(47.93±3.75)and(45.08±3.95)points,which were lower than(49.93±2.52)and(47.85±3.85)points in the control group(P<0.05).On D0-D3,the total incidence of depression in the experimental group was lower than that in the control group,but the difference was not statistically significant(P>0.05).After surgery,4 cases(10.0%)of adverse reactions occurred in the experimental group,including nausea,vomiting,lethargy,dizziness and headache,irritability,fatigue.In the control group,6 cases(15.0%)of adverse reactions occurred,with no significant difference in comparison(P>0.05).Conclusion Esketamine can reduce the degree of postoperative anxiety and depression,improve cognitive cognition on postoperative day 1 in elderly patients with lung cancer undergoing thoracoscopic lobectomy,and reduce the incidence of POD.
NETL
NSTL
万方数据
