Effects of subanesthetic dose of esketamine on postoperative anxiety and recovery in patients undergoing laparoscopic cholecystectomy
- ZHONGGUO YAOFANG Vol. 37, Issue 2, Pages: 204-209(2026)
- 作者机构：
1.苏州大学附属苏州九院麻醉科，江苏 苏州 215200
2.江苏大学附属昆山医院药学部，江苏 苏州 215300
- 作者简介：
- 基金信息：
DOI：10.6039/j.issn.1001-0408.2026.02.12
CLC： R971+.2;R614.2Received：23 July 2025，
Revised：2025-12-26，
Accepted：29 December 2025，
Published：30 January 2026
- 稿件说明：
移动端阅览
钟章珍,郑显,徐婷,等.亚麻醉剂量艾司氯胺酮对腹腔镜胆囊切除术患者术后焦虑及恢复的影响[J].中国药房,2026,37(02):204-209.
ZHONG Zhangzhen,ZHENG Xian,XU Ting,et al.Effects of subanesthetic dose of esketamine on postoperative anxiety and recovery in patients undergoing laparoscopic cholecystectomy[J].ZHONGGUO YAOFANG,2026,37(02):204-209.
钟章珍,郑显,徐婷,等.亚麻醉剂量艾司氯胺酮对腹腔镜胆囊切除术患者术后焦虑及恢复的影响[J].中国药房,2026,37(02):204-209. DOI： 10.6039/j.issn.1001-0408.2026.02.12.
ZHONG Zhangzhen,ZHENG Xian,XU Ting,et al.Effects of subanesthetic dose of esketamine on postoperative anxiety and recovery in patients undergoing laparoscopic cholecystectomy[J].ZHONGGUO YAOFANG,2026,37(02):204-209. DOI： 10.6039/j.issn.1001-0408.2026.02.12.
摘要
目的
2
探讨亚麻醉剂量艾司氯胺酮对腹腔镜胆囊切除术患者术后焦虑及恢复的影响。
方法
2
选择2023年1月到2024年12月于苏州大学附属苏州九院行腹腔镜胆囊切除术患者200例，按随机数字表法分为对照组和观察组，每组100例。麻醉开始前1 min，对照组患者静脉注射丙泊酚乳状注射液+枸橼酸舒芬太尼注射液+氯化琥珀胆碱注射液；观察组患者在此基础上，静脉注射盐酸艾司氯胺酮注射液。比较两组患者的焦虑状态，术中一般情况（舒芬太尼用量、气腹持续时间、手术时间、麻醉时间和拔管时间），术后恢复情况、不良反应发生情况及地佐辛补救镇痛情况；不同时间点的心率、平均动脉压、熵指数（状态熵、反应熵）、炎症因子水平（白细胞介素6、C反应蛋白）、疼痛程度的数字评分（NRS）。
结果
2
两组患者的气腹持续时间、手术时间、麻醉时间、拔管时间、术后口干发生率、熵指数、出室时间比较，差异均无统计学意义（
P
＞0.05）。与对照组比较，观察组患者术后状态-特质焦虑问卷评分，术中舒芬太尼用量，术后恶心、呕吐、寒战的发生率，地佐辛补救镇痛患者比例和术后24 h血浆白细胞介素6、C反应蛋白水平，以及NRS均显著减少或降低（
P
＜0.05）；观察组患者手术开始时、手术结束时、拔管时的心率和平均动脉压均显著高于对照组（
P
＜0.05）。
结论
2
亚麻醉剂量艾司氯胺酮可有效减轻腹腔镜胆囊切除术患者的术后焦虑、减少术中阿片类药物用量、抑制术后炎症反应、缓解术后疼痛并促进术后恢复。
Abstract
OBJECTIVE
2
To investigate the effects of subanesthetic dose of esketamine on postoperative anxiety and recovery in patients undergoing laparoscopic cholecystectomy.
METHODS
2
A total of 200 patients scheduled for laparoscopic cholecystectomy at Suzhou Ninth Hospital Affiliated to Soochow University from January 2023 to December 2024 were randomly assigned to control group （
n
＝100） and observation group （
n
＝100）. One minute before the initiation of anesthesia， patients in the control group received intravenous injections of Propofol emulsion injection， Sufentanil citrate injection， and Succinylcholine chloride injection. On this basis， patients in the observation group received an intravenous injection of Esketamine hydrochloride injection. The anxiety status of patients in both groups was compared， along with their general intraoperative conditions （including sufentanil dosage， duration of pneumoperitoneum， operative time， anesthesia time， and extubation time）， postoperative recovery， incidence of adverse reactions， and the need for dezocine rescue analgesia. Heart rate and mean arterial pressure， entropy index （state entropy and response entropy）， inflammatory marker levels [interleukin-6 （IL-6） and C-reactive protein （CRP）
]
， numerical rating scale （NRS） for pain intensity were compared between the two groups at different time points.
RESULTS
2
No significant differences were found between the two groups in pneumoperitoneum duration， operative time， anesthesia time， extubation time， incidence of postoperative dry mouth， entropy index or length of stay in the post-anesthesia care unit （
P
＞0.05）. Compared with the control group， the observation group showed significantly lower postoperative STAI-S scores， reduced intraoperative sufentanil consumption， decreased incidence of postoperative nausea， vomiting， and shivering， the need for dezocine rescue analgesia， as well as lower plasma IL-6 and CRP levels at 24 h after surgery， and NRS （
P
＜0.05）. The heart rate and mean arterial pressure of patients in the observation group at the start of surgery， end of surgery， and during extubat
ion were all significantly higher than those in the control group （
P
＜0.05）.
CONCLUSIONS
2
Subanesthetic dose of esketamine can effectively alleviate postoperative anxiety， reduce intraoperative opioid consumption， suppress postoperative inflammatory response， relieve postoperative pain， and promote recovery in patients undergoing laparoscopic cholecystectomy.
关键词
Keywords
references
TURRADO V ， GUZMÁN Y ， JIMÉNEZ-LILLO J ， et al . Exposure to virtual reality as a tool to reduce peri-operative anxiety in patients undergoing colorectal cancer surgery：a single-center prospective randomized clinical trial [J ] . Surg Endosc ， 2021 ， 35 （ 7 ）： 4042 - 4047 .
SHEBL M A ， TORAIH E ， SHEBL M ， et al . Preoperative anxiety and its impact on surgical outcomes：a systematic review and meta-analysis [J ] . J Clin Transl Sci ， 2025 ， 9 （ 1 ）： e33 .
ZHAO L ， LI Z Y ， JIN B ， et al . Safety and efficacy of low-dose esketamine in laparoscopic cholecystectomy：a pros-pective，double-blind randomized controlled trial [J ] . BMC Anesthesiol ， 2024 ， 24 （ 1 ）： 47 .
FU D J ， ZHANG Q Y ， SHI L ， et al . Esketamine versus placebo on time to remission in major depressive disorder with acute suicidality [J ] . BMC Psychiatry ， 2023 ， 23 （ 1 ）： 587 .
FALK E ， SCHLIEPER D ， VAN CASTER P ， et al . A rapid positive influence of S-ketamine on the anxiety of patients in palliative care：a retrospective pilot study [J ] . BMC Palliat Care ， 2020 ， 19 （ 1 ）： 1 .
ZHANG Y ， LI S Q ， WU C ， et al . Effect of perioperative subanesthetic dose of esketamine on postoperative reco-very quality in patients undergoing laparoscopic gastrointestinal surgery：a randomised，double-blind，controlled trial [J ] . Drug Des Devel Ther ， 2025 ， 19 ： 6637 - 6646 .
FERNÁNDEZ-CASTRO M ， JIMÉNEZ J M ， MARTÍN-GIL B ， et al . The influence of preoperative anxiety on postoperative pain in patients undergoing cardiac surgery [J ] . Sci Rep ， 2022 ， 12 （ 1 ）： 16464 .
Jr RIZZO M G ， 2nd COSTELLO J P ， LUXENBURG D ， et al . Augmented reality for perioperative anxiety in patients undergoing surgery：a randomized clinical trial [J ] . JAMA Netw Open ， 2023 ， 6 （ 8 ）： e2329310 .
HAUCK A G V ， VAN DER VAART M ， ADAMS E ， et al . Effect of parental touch on relieving acute procedural pain in neonates and parental anxiety（Petal）：a multicentre，randomised controlled trial in the UK [J ] . Lancet Child Adolesc Health ， 2024 ， 8 （ 4 ）： 259 - 269 .
CHO S ， KIM Y J ， LEE M J ， et al . Cut-off points between pain intensities of the postoperative pain using receiver operating characteristic（ROC）curves [J ] . BMC Anesthesiol ， 2021 ， 21 （ 1 ）： 29 .
LI S ， LIU H ， ZHANG J ， et al . The 95% effective dose of intranasal dexmedetomidine sedation for pulmonary function testing in children aged 1-3 years：a biased coin design up-and-down sequential method [J ] . J Clin Anesth ， 2020 ， 63 ： 109746 .
HAWKER G A ， MIAN S ， KENDZERSKA T ， et al . Measures of adult pain：visual analog scale for pain（VAS pain），numeric rating scale for pain（NRS pain），McGill pain questionnaire（MPQ），short-form McGill pain questionnaire（SF-MPQ），chronic pain grade scale（CPGS），short form-36 bodily pain scale（SF-36 BPS），and measure of intermittent and constant osteoarthritis pain（ICOAP） [J ] . Arthritis Care Res（Hoboken） ， 2011 ， 63 （ Suppl.11 ）： S240 - S252 .
CHU T T ， ZHOU S Q ， WAN Y F ， et al . Comparison of remimazolam and propofol combined with low dose esketa-mine for pediatric same-day painless bidirectional endoscopy：a randomized，controlled clinical trial [J ] . Front Pharmacol ， 2024 ， 15 ： 1298409 .
万幸 ， 杨青青 ， 樊迪 ， 等 . 亚麻醉剂量艾司氯胺酮复合丙泊酚应用于无痛胃肠镜检查的效果 [J ] . 临床麻醉学杂志 ， 2022 ， 38 （ 2 ）： 144 - 148 .
SZUHANY K L ， SIMON N M . Anxiety disorders：a review [J ] . JAMA ， 2022 ， 328 （ 24 ）： 2431 - 2445 .
KOPRA E ， MONDELLI V ， PARIANTE C ， et al . Keta-mine’s effect on inflammation and kynurenine pathway in depression：a systematic review [J ] . J Psychopharmacol ， 2021 ， 35 （ 8 ）： 934 - 945 .
PEIRCE J M ， ALVIÑA K . The role of inflammation and the gut microbiome in depression and anxiety [J ] . J Neurosci Res ， 2019 ， 97 （ 10 ）： 1223 - 1241 .
HALARIS A ， COOK J . The glutamatergic system in treatment-resistant depression and comparative effectiveness of ketamine and esketamine：role of inflammation? [M ] // Neuroinflammation，gut-brain axis and immunity in neuropsychiatric disorders . Singapore ： Springer Nature Singapore ， 2023 ： 487 - 512 .
BRINCK E C V ， VIRTANEN T ， MÄKELÄ S ， et al . S-ketamine in patient-controlled analgesia reduces opioid consumption in a dose-dependent manner after major lumbar fusion surgery：a randomized，double-blind，placebo-controlled clinical trial [J ] . PLoS One ， 2021 ， 16 （ 6 ）： e0252626 .
PEREZ-RUIXO C ， ROSSENU S ， ZANNIKOS P ， et al . Population pharmacokinetics of esketamine nasal spray and its metabolite noresketamine in healthy subjects and patients with treatment-resistant depression [J ] . Clin Pharmacokinet ， 2021 ， 60 （ 4 ）： 501 - 516 .
TRIMMEL H ， HELBOK R ， STAUDINGER T ， et al . S（+）-ketamine：current trends in emergency and intensive care medicine [J ] . Wien Klin Wochenschr ， 2018 ， 130 （ 9/10 ）： 356 - 366 .
BELL R F ， DAHL J B ， MOORE R A ， et al . Peri-operative ketamine for acute post-operative pain：a quantitative and qualitative systematic review（cochrane review） [J ] . Acta Anaesthesiol Scand ， 2005 ， 49 （ 10 ）： 1405 - 1428 .
PIPER S N ， BESCHMANN R B ， MENGISTU A ， et al . Postoperative analgosedation with S（+）-ketamine decreases the incidences of postanesthetic shivering and nausea and vomiting after cardiac surgery [J ] . Med Sci Monit ， 2008 ， 14 （ 12 ）： PI59 - PI65 .
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