围术期神经认知障碍和术后抑郁症状是术后显着的并发症。研究表明，艾氯胺酮具有神经保护和抗抑郁作用。该试验纳入了 209 名年龄在 60 至 86 岁接受肿瘤切除术的患者，他们在手术期间和术后接受了艾氯胺酮（E 组）或未服用（C 组）。 E组患者在全身麻醉诱导10分钟后静脉注射0.5 mg/kg的艾氯胺酮。此外，术后48小时内使用艾氯胺酮（2 mg/kg）联合舒芬太尼进行PCIA。另一方面，C组用生理盐水代替艾氯胺酮。通过神经心理学测试和认知状态修正电话访谈评估认知功能，并使用汉密尔顿抑郁量表17评估抑郁症状。与C组比较，E组患者在术后3、7和90天表现出较低的抑郁症状发生率（53.9% vs 67.7%、26.3% vs 47.9%、13.3% vs 28.4%）。 E 组在第 7 天和第 90 天的追踪测试时间也有所减少。然而，两组术后 1 至 5 天的谵妄发生率或术后 90 天的认知障碍发生率没有显着差异（12.1%）术中小剂量艾氯胺酮和术后小剂量艾氯胺酮联合舒芬太尼静脉自控镇痛已被证明可以改善术后镇痛，减轻术后抑郁症状，并有助于术后恢复。社会执行能力。然而，这种方法并没有减少术后谵妄或术后认知功能障碍的发生率。版权所有 © 2024 作者。由 Wolters Kluwer Health, Inc. 出版

Perioperative neurocognitive disorder and postoperative depressive symptoms are significant complications after surgery. Studies have indicated that esketamine possesses neuroprotective and antidepressant qualities.This trial included 209 patients aged 60 to 86 years undergoing tumor resection who received esketamine (Group E) or not (Group C) during and after surgery. In group E, patients were given an intravenous dose of 0.5 mg/kg of esketamine 10 minutes after induction of general anaesthesia. In addition, esketamine (2 mg/kg) in combination with sufentanil was used for PCIA during 48 hours postoperatively. On the other hand, saline was used as a substitute for esketamine in group C. Cognitive function was evaluated using neuropsychological tests and telephone interview for cognitive status-modified, and symptoms of depression were assessed using Hamilton Depression Rating Scale 17.Compared to Group C, patients in Group E exhibited lower rates of depressive symptoms at 3, 7, and 90 days post-surgery (53.9% vs 67.7%, 26.3% vs 47.9%, and 13.3% vs 28.4%). Group E also showed decreased time for Trail Making Test on days 7 and 90. However, there were no significant differences in the incidence of delirium 1 to 5 days post-surgery or cognitive impairment 90 days post-surgery between the 2 groups (12.1% vs 10.9% and 8.4% vs 9.7%).Intraoperative low-dose esketamine and postoperative low-dose esketamine combined with sufentanil for patient-controlled intravenous analgesia has been shown to improve postoperative analgesia, alleviate postoperative depressive symptoms, and aid in the recovery of social executive ability. However, this approach did not reduce the incidence of postoperative delirium or postoperative cognitive dysfunction.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.