ObjectiveTo study the effects of esketamine on pain mediators and early postoperative depression in patients undergoing laparoscopic surgery.

MethodsA total of 60 patients who underwent laparoscopic surgery were selected and randomly divided into esketamine group (group S, n=30) and control group (group C, n=30). In group S, patients were received 0.2 mg/kg esketamine intravenously after anesthesia induction followed by infusing continuously at a dose of 0.1 mg·kg^-1·h^-1 until 20 minutes before the end of surgery. In group C, patients were given the same amount of 0.9% sodium chloride solution in the same way. The incidence of postoperative nausea, vomiting and respiratory depression, visual analogue score (VAS) at the time of recovery (T₁), 6 h after surgery (T₂) and 24 h after surgery (T₃), prostaglandin E2 (PGE2), substance P (SP) and β-endorphin (β-EP) level at the time of pre-anesthesia (T₀), recovery (T₁), 6 h after surgery (T₂) and 24 h after surgery (T₃), and PHQ-9 score at time of pre-anesthesia (T₀), recovery (T₁) and 72 h after surgery (T₄) were recorded.

ResultsThere was no significant difference in the incidence of postoperative adverse reactions between two groups (P>0.05). The VAS scores at T₁ and T₂ in group S were lower than those in group C (P < 0.01 and P < 0.05). There was no difference in the levels of PEG2, SP and β-EP at T₀ between two groups (P>0.05). The levels of PEG2 and SP at T₁-T₃ and the levels of β-EP at T₁ and T₂ in group S were lower than those in group C (P < 0.05 to P < 0.01). There was no difference in PHQ-9 score at T₀ between two groups (P>0.05). Compared to group C, PHQ-9 score at T₄ in group S were lower (P < 0.05).

ConclusionsUsing esketamine in general anesthesia undergoing laparoscopic surgery can provide well postoperative analgesia, inhibit the secretion of pain mediators, improve early postoperative depression of patients, and do not increase the incidence of postoperative adverse reactions.