Effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection

LU Yanfeng; DAI Jiabao; WU Zhouquan; ZOU Zhiqing

doi:10.7619/jcmp.20234042

Journal of Clinical Medicine in Practice > 2024 > 28(9): 90-94. > DOI: 10.7619/jcmp.20234042

LU Yanfeng, DAI Jiabao, WU Zhouquan, ZOU Zhiqing. Effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 90-94. DOI: 10.7619/jcmp.20234042

Citation:

PDF (763 KB)

Effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection

Department of Anesthesiology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu, 213000

More Information

Received Date: December 12, 2023
Revised Date: February 26, 2024
Available Online: May 14, 2024

Graphical Abstract

Abstract

Abstract

Objective
To investigate the effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection.
Methods
A total of 120 patients with selective thoracoscopic pulmonary nodule resection were randomly divided into low-dose esketamine group (group L), high-dose esketamine group (group H) and saline control group (group C), with 40 cases in each group. Before skin incisionafter anesthetic induction, 0.25 mg/kgesketamine, 0.50 mg/kg esketamine and the equivalent amount of saline were separately administered for patients in the three groups. Visual Analogue Scale (VAS) score for pain and the Self-rating Depression Scale (SDS) score were compared among the three groups at the time points of one day before surgery (T₀), one day after surgery (T₁), three days after surgery (T₂), and the day of discharge (T₃), and postoperative analgesia within 24 h and perioperative adverse reactions were also recorded.
Results
The VAS scores for rest and coughing at T₁ were significantly lower in group L and group H than group C (P < 0.05); compared with group C, the total press number of analgesic pump with in 24 h and effective press number were significantly decreased in group L and group H, and the dosage of sufentanil was also significantly decreased(P < 0.05). There were no significant differences in depression scores at different time points among the three groups (P>0.05). There were no significant differences in the incidence rates of nausea, vomiting, dizziness, hallucinations, and nightmares among the three groups (P>0.05).
Conclusion
Esketamine can effectively alleviate pain on the first day after operation and reduce the dosage of opioid analgesics without increasing the incidence of adverse reactions in patients with thoracoscopic pulmonary nodule resection; compared with 0.25 mg/kg esketamine, 0.50 mg/kg esketamine doesn't demonstrate better postoperative analgesia or improvement in perioperative depression.
- esketamine,
- pulmonary nodule,
- thoracoscopic pulmonary nodule resection,
- pain,
- depression,
- adverse reactions

FullText(HTML)

References (22)

References

[1]	LI L H, ZHAO Y, LI H. Assessment of anxiety and depression in patients with incidental pulmonary nodules and analysis of its related impact factors[J]. Thorac Cancer, 2020, 11(6): 1433-1442. doi: 10.1111/1759-7714.13406
[2]	喻静, 刘林, 龚卫娟. 反刍思维在肺结节患者领悟社会支持与焦虑及抑郁情绪中的中介作用[J]. 实用临床医药杂志, 2023, 27(7): 45-50. doi: 10.7619/jcmp.20222997
[3]	ZHANG J Y, WANG F, DANG J J, et al. Effect of intraoperative infusion of esketamine on quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery: arandomized controlled trial[J]. Pain Ther, 2023, 12(4): 979-992. doi: 10.1007/s40122-023-00519-9
[4]	UCHITOMI Y, MIKAMI I, NAGAI K J, et al. Depression and psychological distress in patients during the year after curative resection of non-small-cell lung cancer[J]. J Clin Oncol, 2003, 21(1): 69-77. doi: 10.1200/JCO.2003.12.139
[5]	WANG X M, LIN C, LAN L F, et al. Perioperative intravenous S-ketamine for acute postoperative pain in adults: a systematic review and meta-analysis[J]. J Clin Anesth, 2021, 68: 110071. doi: 10.1016/j.jclinane.2020.110071
[6]	NG J, ROSENBLATJ D, LUI L M W, et al. Efficacy of ketamine and esketamine on functional outcomes in treatment-resistant depression: a systematic review[J]. J Affect Disord, 2021, 293: 285-294. doi: 10.1016/j.jad.2021.06.032
[7]	ZHAO H, XIN L, FENG Y. The effect of preoperative erector spinae plane vs. paravertebral blocks on patient-controlled oxycodone consumption after video-assisted thoracic surgery: a prospective randomized, blinded, non-inferiority study[J]. J Clin Anesth, 2020, 62: 109737. doi: 10.1016/j.jclinane.2020.109737
[8]	朱云柯, 林琳, 廖虎, 等. 中国胸外科围手术期疼痛管理专家共识(2018版)[J]. 中国胸心血管外科临床杂志, 2018, 25(11): 921-928. doi: 10.7507/1007-4848.201810052
[9]	ADEGBOLA A, GRITSENKO K, MEDRANOE M. Perioperative use of ketamine[J]. Curr Pain Headache Rep, 2023, 27(9): 445-448. doi: 10.1007/s11916-023-01128-z
[10]	赵若林, 梁丽丽, 尚学栋, 等. 艾司氯胺酮联合胸椎旁神经阻滞对胸腔镜肺癌根治术后恢复质量的影响[J]. 临床麻醉学杂志, 2023, 39(7): 677-682. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202307001.htm
[11]	KITAGAWA R, YASUI-FURUKORI N, TSUSHIMA T, et al. Depression increases the length of hospitalization for patients undergoing thoracic surgery: a preliminary study[J]. Psychosomatics, 2011, 52(5): 428-432. doi: 10.1016/j.psym.2011.03.010
[12]	刘硕, 刘晓红. 如何利用自评式量表在老年人群中筛查抑郁[J]. 中国临床保健杂志, 2020, 23(5): 586-589. doi: 10.3969/J.issn.1672-6790.2020.05.003
[13]	YAO J X, SONG T T, ZHANG Y, et al. Intraoperative ketamine for reduction in postpartum depressive symptoms after cesarean delivery: a double-blind, randomized clinical trial[J]. Brain Behav, 2020, 10(9): e01715. doi: 10.1002/brb3.1715
[14]	JIANG M, LI Q Q, MAO M J, et al. Evaluation of clinical effects of Esketamine on depression in patients with missed miscarriage: a randomized, controlled, double-blind trial[J]. J Affect Disord, 2023, 329: 525-530. doi: 10.1016/j.jad.2023.02.127
[15]	陈逸斐. 亚麻醉剂量艾司氯胺酮对腹腔镜减重手术患者疼痛及情绪的作用与影响[D]. 广州: 暨南大学, 2021.
[16]	MASHOURG A, BEN ABDALLAH A, PRYORK O, et al. Intraoperative ketamine for prevention of depressive symptoms after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial[J]. Br J Anaesth, 2018, 121(5): 1075-1083. doi: 10.1016/j.bja.2018.03.030
[17]	MAJ H, WANGS Y, YUH Y, et al. Prophylactic use of ketamine reduces postpartum depression in Chinese women undergoing cesarean section[J]. Psychiatry Res, 2019, 279: 252-258. doi: 10.1016/j.psychres.2019.03.026
[18]	SALAHUDEENM S, WRIGHTC M, PETERSONG M. Esketamine: new hope for the treatment of treatment-resistant depression A narrative review[J]. Ther Adv Drug Saf, 2020, 11: 2042098620937899.
[19]	KOHTALA S. Ketamine-50years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms[J]. Pharmacol Rep, 2021, 73(2): 323-345. doi: 10.1007/s43440-021-00232-4
[20]	杨春, 刘寒玉, 刘存明. 艾司氯胺酮的临床应用进展[J]. 临床麻醉学杂志, 2023, 39(4): 414-417. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ202304015.htm
[21]	TAILLEFERDE LAPORTALIōRE T, JULLIEN A, YRONDI A, et al. Reporting of harms in clinical trials of esketamine in depression: a systematic review[J]. Psychol Med, 2023, 53(10): 4305-4315. doi: 10.1017/S0033291723001058
[22]	ZHANG Y, CUI F, MAJ H, et al. Mini-dose esketamine-dexmedetomidine combination to supplement analgesia for patients after scoliosis correction surgery: a double-blind randomised trial[J]. Br J Anaesth, 2023, 131(2): 385-396. doi: 10.1016/j.bja.2023.05.001

Cited By

Get Citation

PDF

XML

Article views (134) PDF downloads (7)

Turn off MathJax

Article Contents

Abstract

References

Effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection

Abstract

References

Catalog

Export File

Citation

Format

Content