111536
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
静脉注射亚麻醉剂量艾司氯胺酮对老年患者胸腔镜肺手术术后早期疼痛的影响：一项随机双盲对照试验
Authors Zhao H , Liu Z, Zhang Y, Liu M, Ning Y, Gao D , Hui K, Ji Q, Zhang L
Received 7 September 2025
Accepted for publication 5 December 2025
Published 18 December 2025 Volume 2025:19 Pages 11289—11305
DOI https://doi.org/10.2147/DDDT.S565937
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Tamer Ibrahim
Haishu Zhao,1,* Zhi Liu,1,* Yue Zhang,2 Mengna Liu,2 Yao Ning,1 Dapeng Gao,1 Kangli Hui,1 Qing Ji,1 Lidong Zhang1
1Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China; 2Department of Anesthesiology, Nanjing Jinling Hospital, Medical College of Nanjing Medical University, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lidong Zhang, Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China, Email ldzhang1968@163.com Qing Ji, Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China, Email qing_ji@nju.edu.cn
Purpose: Thoracic surgery is one of the postoperative surgical procedures with the most severe pain. This study aimed to assess whether intraoperative subanesthetic esketamine could reduce the proportion of elderly patients experiencing moderate-to-severe pain following thoracoscopic lung resection.
Patients and Methods: A total of 136 elderly patients undergoing thoracoscopic pulmonary surgery were randomly assigned to two groups: the esketamine group (0.25 mg/kg loading, 0.25 mg/kg/h infusion) and the control group (received normal saline). The primary outcome was the proportion of patients experiencing moderate-to-severe pain on the first postoperative day (POD1), defined as a Numerical Rating Scale (NRS) pain score ≥ 4 during coughing. The secondary outcomes were the postoperative Athens Insomnia Scale (AIS), Hospital Anxiety and Depression Scale (HADS) scores, opioid consumption, hemodynamics, and adverse events.
Results: The primary outcome incidence was lower in the esketamine group (51.5% [35/68]) than in the control group (69.1% [47/68]; relative risk [RR], 0.75; 95% confidence interval [CI], 0.56– 0.99; P = 0.035). The proportion of patients with moderate-to-severe pain in the esketamine group decreased by 25.5%. The analysis revealed an absolute risk reduction (ARR) of 17.6% and a number needed to treat (NNT) of 5.7 (rounded to 6). The incidence of postoperative sleep disturbance (PSD) on POD1 (23.5% vs 44.1%; RR, 0.53; 95% CI, 0.32– 0.88; P = 0.011) is lower in patients who receive esketamine. Compared to the control group, the esketamine group demonstrated lower HADS scores and reduced opioid consumption, without significant differences in hemodynamic parameters or an increased incidence of neuropsychiatric adverse events.
Conclusion: This study demonstrated that intraoperative subanesthetic esketamine reduced the proportion of moderate-to-severe pain in elderly patients after thoracoscopic surgery, decreased the incidence of sleep disturbances, improved anxiety and depression scores, and lowered opioid consumption, without increasing neuropsychiatric adverse events.
Keywords: esketamine, postoperative analgesia, sleep, multimodal analgesia, thoracoscopic lung surgery
1Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China; 2Department of Anesthesiology, Nanjing Jinling Hospital, Medical College of Nanjing Medical University, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lidong Zhang, Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China, Email ldzhang1968@163.com Qing Ji, Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China, Email qing_ji@nju.edu.cn
Purpose: Thoracic surgery is one of the postoperative surgical procedures with the most severe pain. This study aimed to assess whether intraoperative subanesthetic esketamine could reduce the proportion of elderly patients experiencing moderate-to-severe pain following thoracoscopic lung resection.
Patients and Methods: A total of 136 elderly patients undergoing thoracoscopic pulmonary surgery were randomly assigned to two groups: the esketamine group (0.25 mg/kg loading, 0.25 mg/kg/h infusion) and the control group (received normal saline). The primary outcome was the proportion of patients experiencing moderate-to-severe pain on the first postoperative day (POD1), defined as a Numerical Rating Scale (NRS) pain score ≥ 4 during coughing. The secondary outcomes were the postoperative Athens Insomnia Scale (AIS), Hospital Anxiety and Depression Scale (HADS) scores, opioid consumption, hemodynamics, and adverse events.
Results: The primary outcome incidence was lower in the esketamine group (51.5% [35/68]) than in the control group (69.1% [47/68]; relative risk [RR], 0.75; 95% confidence interval [CI], 0.56– 0.99; P = 0.035). The proportion of patients with moderate-to-severe pain in the esketamine group decreased by 25.5%. The analysis revealed an absolute risk reduction (ARR) of 17.6% and a number needed to treat (NNT) of 5.7 (rounded to 6). The incidence of postoperative sleep disturbance (PSD) on POD1 (23.5% vs 44.1%; RR, 0.53; 95% CI, 0.32– 0.88; P = 0.011) is lower in patients who receive esketamine. Compared to the control group, the esketamine group demonstrated lower HADS scores and reduced opioid consumption, without significant differences in hemodynamic parameters or an increased incidence of neuropsychiatric adverse events.
Conclusion: This study demonstrated that intraoperative subanesthetic esketamine reduced the proportion of moderate-to-severe pain in elderly patients after thoracoscopic surgery, decreased the incidence of sleep disturbances, improved anxiety and depression scores, and lowered opioid consumption, without increasing neuropsychiatric adverse events.
Keywords: esketamine, postoperative analgesia, sleep, multimodal analgesia, thoracoscopic lung surgery