Impact of Combining Esketamine With Erector Spinae Plane Block on Opioid Consumption, Inflammatory Stress, and Cognitive Function After Thoracoscopic Surgery
Bibliographic record
Abstract
Aims/Background Esketamine exhibits strong sedative and analgesic effects. Similarly, erector spinae plane block (ESPB) blocks somatic and visceral nerves and is commonly used for pain relief in thoracic surgery. Therefore, this study aims to investigate the impacts of combining esketamine with ESPB on opioid consumption, inflammatory stress, and cognitive function after thoracoscopic surgery. Methods This retrospective study collected clinical data from 114 patients who underwent thoracoscopic surgery at Jinhua Municipal Central Hospital, between January 2022 and January 2024. Based on anesthesia approaches, patients were divided into the ESPB (n = 62) and esketamine + ESPB groups (n = 52). Several variables, such as perioperative indicators, postoperative recovery, inflammatory stress, and cognitive function were compared between the two groups. Results In both groups, the Numeric Rating Scale (NRS) score increased at 6 h postoperatively compared to at 1h, and gradually decreased at 12 h, 24 h, and 48 h (p < 0.05). Compared to the ESPB group, the NRS score was significantly decreased in the esketamine + ESPB group at 6 h, 12 h, 24 h, and 48 h after surgery (p < 0.001). The oxycodone consumption was significantly lower in the esketamine + ESPB group at 24 h and 48 h post-surgery than in the ESPB group (p < 0.001). Furthermore, the incidence of adverse reactions was 30.6% (19/62) in the ESPB group and 34.6% (18/52) in the esketamine + ESPB group, with the difference being statistically insignificant (p = 0.652). Compared to the ESPB group, the white blood cell (WBC) count, C-reactive protein (CRP), procalcitonin (PCT), interleukin (IL)-6, and tumor necrosis factor (TNF)-α levels were significantly decreased in the Esketamine + ESPB group at day 3 after surgery (p < 0.001). Compared to the ESPB group, the Montreal Cognitive Assessment Scale (MoCA) score was substantially elevated in the esketamine + ESPB group at days 1 and 3 after surgery (p < 0.001, p = 0.001). Conclusion The combination of esketamine and ESPB effectively alleviated postoperative pain and reduced opioid consumption after thoracoscopic surgery. Furthermore, the combined approach significantly improved postoperative inflammatory stress and cognitive impairment compared to the use of ESPB alone without increasing adverse reactions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".