Effect of esketamine on early postoperative mental state in patients with breast cancer

Corresponding author: zhou sen, 21823398@qq.com

DOI: 10.12201/bmr.202412.00054

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  Abstract: Objective To observe the effect of esketamine combined with type II thoracic nerve block on early mental state of patients undergoing modified radical mastectomy. Methods 100 patients undergoing modified radical mastectomy were randomly divided into control group (50 patients) and experimental group (50 patients). Patients in both groups were routinely anesthetised and underwent type II thoracic nerve block under ultrasound guidance. The experimental group was given a single intravenous injection of esketamine 0.25mg/kg before incision, while the control group was injected with the same amount of normal saline. The general condition and duration of operation, nausea and vomiting, hallucinations and nightmares, agitation, lethargy and VAS score on the first day after surgery were recorded in both groups. Venous blood was collected 1 day before surgery (T0), 1 day after surgery (T1) and 3 days after surgery (T2), and BDNF, TNF-α and IL-1β were measured. Meanwhile, HAMD and HAMA were evaluated. The difference of the FACT-B of breast cancer patients between the two groups at the first outpatient visit after surgery was analyzed. Results Compared with control group, the scores of TNF-α, IL-1β, HAMA and HAMD were decreased at T1 and T2 time points, and the level of BDNF was increased (P < 0.05). On FACT-B, the scores of the experimental group were significantly better than those of the control group (P < 0.05). VAS scores, nausea and vomiting, hallucinations and nightmares, agitation and lethargy were not statistically significant between the two groups (P > 0.05). Conclusion The subanesthetic dose of esketamine combined with nerve block can improve the postoperative mental status of breast cancer patients.

  Key words: Esketamine; Radical mastectomy; Anxiety and depression; Quality of life

  Submit time: 23 December 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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