Effect of oxycodone combined with esketamine on pain and adverse reactions after laparoscopic radical resection of colorectal cancer
Jing Jun
Wang Ya-zhen
Li Xin
Song Lu
Chen Mei-yin
Abstract：Objective To investigate the effect of oxycodone combined with esketamine on pain and adverse reactions after laparoscopic radical resection of colorectal cancer.Methods A total of 90 patients who were scheduled to undergo laparoscopic radical resection of colorectal cancer and admitted to the People's Hospital of Ma'anshan City,Anhui Province from February 2023 to April 2024 were selected and randomly divided into the oxycodone group,the oxycodone combined with esketamine group,and the sufentanil group,with 30 in each group.The postoperative incision visual analogue scale(VAS)score,Hamilton depression scale(HAMD)score,serum brain-derived neurotrophic factor(BDNF),5-hydroxytryptamine(5-HT)expression level,and adverse reactions were compared among the three groups.Results The postoperative VAS scores of all three groups showed a downward trend.The VAS score of the immediate oxycodone combined with esketamine group((2.70±1.02)points)was lower than those of the oxycodone group and the sufentanil group((3.40±1.30)points and(3.47±0.94)points,respectively)(t=2.320,3.041,both P<0.05).The VAS scores in the oxycodone combined with esketamine group and the sufentanil group were lower than those in the oxycodone group at 12,24,and 48 hours after surgery(P<0.05).There were no statistically significant differences in VAS scores among the three groups at the time of postanesthesia care unit(PACU)discharge,2 hours after surgery,and 6 hours after surgery(P>0.05).At the time of 1 day and 7 days after surgery,the HAMD scores in the oxycodone combined with esketamine group((9.87±1.76)points and(9.53±1.41)points,respectively)were lower than those in the oxycodone group((14.37±3.1)points and(15.83±2.93)points,respec-tively),but higher than those in the sufentanil group((7.57±2.03)points and(7.43±2.13)points,respectively)(t=12.987,10.612,4.689,4.503,all P<0.05).Compared with pre-operative levels,the serum BDNF levels in all three groups showed a downward trend at the time of 1 day and 7 days after surgery,while the 5-HT levels showed an upward trend(P<0.05).At the time of 1 day and 7 days after surgery,the BDNF levels in the oxycodone combined with esketamine group((150.54±2.33)pg·mL-1 and(155.34±4.68)pg·mL-1,respectively)were higher than those in the oxycodone group((140.54±2.64)pg·mL-1 and(142.62±3.96)pg·mL-1,respectively)and in the sufentanil group((139.37±2.78)pg·mL-1 and(141.38±4.11)pg·mL-1,respectively).The 5-HT levels((115.24±3.45)pg·mL-1 and(110.54±4.29)pg·mL-1,respectively)were lower than those in the oxycodone group((125.24±3.15)pg·mL-1 and(123.45±5.61)pg·mL-1,respectively)and in the sufentanil group((128.76±3.17)pg·mL-1 and(125.17±4.73)pg·mL-1,respectively)(t=9.441,16.867,11.364,12.276,11.724,15.805,10.012,12.549,all P<0.001).The total adverse reaction rates were 10.00%in the oxycodone group,16.67%in the oxycodone combined with esketamine group,and 16.67%in the sufentanil group.There was no statistically significant difference among the three groups(χ2=0.719,P=0.698).Conclusion Oxycodone combined with esketamine has pos-itive analgesic and sedative effect on pain management after laparoscopic radical resection of colorectal cancer,which can improve patients'postoperative psychological state and neurotransmitter levels,without increasing the incidence of adverse reactions.
Keywords：OxycodoneEsketamineRadical resection of colorectal cancerPostoperative analgesiaAntidepression
Publication Date：2025-02-24
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 101-105 )