Effect Of Esketamine On Perioperative Anxiety And Depression In Patients Undergoing Laparoscopic Cholecystectomy

Aim:Anxiety and depression is common in patients undergoing surgery.There are fewer studies on how anesthesiologists can quickly alleviate anxiety and depression in surgical patients.This study investigated the effects of a single preoperative intravenous esketamine on perioperative anxiety and depression of surgical patients undergoing laparoscopic cholecystectomy.Methods:This randomized,double-blind placebo-controlled study was conducted from October 2021 to December 2022 at Zhujiang Hospital of Southern Medical University.One hundred and thirty-four subjects were included in the study and randomized into two groups,with group E receiving 0.25 mg/kg esketamine intravenously before anesthesia and group C receiving an equal amount of saline intravenously.The APAIS,HADS,VAS-A was used preoperatively,and on the first and second postoperative days.The NRS was repeated on the first and second postoperative days.Patient satisfaction scores were performed on the second day after surgery.The incidence of postoperative mood distress(defined here as anxiety and depression,i.e.,scores≥8 on the Hospital Anxiety Scale or ≥5 on the Visual Analogue Scale).The change in scores on the HADS and the VAS-A in the two groups were observed in two groups.Result:A total of 133 patients completed the trial and entered the analysis phase of the study results,group C(n=66),and group E(n=67).Compared with group C patients,group E patients had a significant lower incidence of perioperative mood distress on the first postoperative day(17.91%vs 30.30%;odds ratio[OR],1.99[95%CL 1.12-3.55];P=0.02)and the second postoperative day(11.94%vs 25.76%;OR,2.56[95%CL 1.33-4.91];P=0.00.The average points that group E patients scored in the HADS,VAS-A were significantly lower than those in group C on the first and second postoperative days(P<0.05).In the group E patients,the HADS and VAS-A score on the first and second postoperative day was significantly lower than those on preoperative day(P<0.05).In the group C patients,there was no significantly difference in the scores of HADS and VAS-A on the first and second postoperative days compared with those on preoperative day.There were no significantly differences in the length of surgery,length of anesthesia,length of stay in the postanesthesia care unit,the hospitalization time,numerical rating scale scores and patient satisfaction scores on the first and second postoperative days between the two groups.Conclusion:Subanesthetic doses of esketamine can rapidly relieve anxiety and depression in perioperative patients,help surgical patients recover quickly after surgery.The findings of this study provide a solution for anesthesiologists to rapidly relieve anxiety and depression in perioperative patients.