| Objective To investigate the effect of esketamine on preoperative anxiety and cognitive decline in gynecological malignant tumor patients undergoing surgery.Methods Eighty-nine patients were selected for elective treatment of gynecological malignant tumors, aged 18 to 64 years old, ASA II or III, BMI 18 to 28 kg/m2, the Hospital Anxiety and Depression Scale (HADS) anxiety subscale score ≥ 8 points and Montreal Cognitive Rating Scale (MoCA) <26 points. The patients were divided into two groups using the random number table method: esketamine group (group S, n=45) and normal saline group (group C, n=44). In group S, 0.2 mg/kg of esketamine was injected intravenously during anesthesia induction, 0.25 mg·kg-1·h-1 was injected by pump during anesthesia maintenance, and 100 mg esketamine was used in the postoperative analgesic pump. Group C was given the same volume of normal saline during anesthesia induction, maintenance and PCIA analgesia, and other medications were the same as those in Group S. HADS and MoCA were used to evaluate patients' anxiety and cognitive function on the 1 day before surgery and on the 1st and 3rd day after surgery. The levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), S100 calcium-binding protein (S100β), and brain-derived neurotrophic factor (BDNF) were detected 1 day before surgery and 3rd day after surgery. The occurrence of adverse reactions 24 hours after surgery was recorded.Results Compared with group C, on the 1st and 3rd day after surgery, the incidence of anxiety was significantly reduced, MoCA cognitive score was increased, serum levels of TNF-α, IL-6, and S100β were significantly reduced, BDNF levels were significantly increased, and postoperative fever was significantly reduced in group S(P<0.05). There was no statistically significant difference in the incidence of other adverse reactions 24 hours after surgery.Conclusions Esketamine can help relieve anxiety and cognitive function of patients, and improve the levels of inflammatory factors and neurorelated proteins in patients with gynecological malignant tumors.
【Key words】 Gynecological malignancy; Anxiety; Cognitive function; Esketamine; Inflammatory factors; Nerve injury protein |
