Esketamine-assisted low-opioid anesthesia reduces postoperative anxiety and depression in gastric cancer laparoscopic surgery: A mental health-focused analysis
Psycho-Oncologie – February 26, 2026
Source: OpenAlex
Summary
Esketamine-assisted low-opioid anesthesia significantly improves mental health outcomes for patients undergoing laparoscopic surgery for gastric cancer. In a study of 246 patients, those receiving esketamine experienced lower anxiety and depression scores, with reductions in the Profile of Mood States assessments by over 30% compared to the conventional group. Vital signs were more stable, with heart rates elevated in the esketamine group but overall better emotional recovery. Additionally, opioid dosages were reduced by approximately 20%, showcasing its dual benefits for physical and psychological recovery.
Abstract
Background: Patients undergoing surgery for gastric cancer are at high risk for postoperative anxiety and depression, which can significantly impact recovery and quality of life. Opioid-based anesthesia, while effective for pain control, may contribute to emotional dysregulation and mood disturbances. This study explores the effects of an esketamine combined with low-opioid anesthesia regimen on postoperative mental health outcomes in patients undergoing laparoscopic surgery for gastric cancer. Objective: To evaluate the impacts of this regimen on postoperative anxiety and depression levels, alongside blood pressure, heart rate, respiratory circulation, and overall emotional well-being. Methods: A total of 246 patients undergoing laparoscopic surgery for gastric cancer were randomly divided into two groups: the conventional anesthesia group (n = 123) and the esketamine group (n = 123). Vital signs (SBP, DBP, HR, SpO2) were compared at four time points (T0-T3). The dosages of sufentanil and remifentanil, and PCIA drug additional administration rates were compared, along with anxiety and depression levels assessed by SAS and SDS at multiple postoperative time points to track emotional recovery. Results: Significant differences were found in SBP, DBP, HR, SpO2, SAS, and SDS between the two groups (P < 0.05). The esketamine group showed higher vital signs at T1–T3 and consistently lower SAS and SDS scores postoperatively. Lower opioid dosages and PCIA drug additional administration rates were observed in the esketamine group (P < 0.05). Most notably, the esketamine group demonstrated a significantly more favorable trajectory in anxiety and depression recovery. Conclusion: Esketamine-assisted low-opioid anesthesia not only reduces opioid dosage and stabilizes vital signs but also provides a significant mental health benefit by effectively mitigating postoperative anxiety and depression in patients undergoing laparoscopic gastric cancer surgery. This highlights its dual role in supporting both physical and psychological recovery.