摘要译文（供参考）

艾司氯胺酮对腹腔镜胃癌切除术后患者术后疲劳综合征的影响：一项随机对照试验

背景： 尽管实施了各种术后管理策略，但在接受腹腔镜根治性胃切除术的个体中，术后疲劳综合征 （POFS） 的患病率仍然相当高。虽然 N-甲基-D-天冬氨酸受体拮抗剂艾司氯胺酮已证明在提高睡眠质量和缓解术后疼痛方面有效，但其对 POFS 的影响仍不确定。因此，本研究的目的是确定艾司氯胺酮围手术期给药是否可以有效减轻腹腔镜根治性胃切除术患者 POFS 的发生。

方法： 共有 133 例诊断为胃癌的患者采用双盲法随机分为两组，即对照组 （C 组） （n = 66） 和艾司氯胺酮组 （E 组） （n = 67）。C 组接受标准化麻醉，而 E 组除标准化麻醉外还接受艾司氯胺酮。评估的主要结局指标是手术后 3 天的 Christensen 疲劳评分，而次要结局包括两组术后疲劳、术后疼痛、睡眠质量和不良反应的差异。

结果： 在接受艾司氯胺酮的组中，Christensen 术后第 3 天的疲劳评分显著低于 C 组（估计差异，-0.70;95% CI，-1.37 至 -0.03;P = 0.040）。此外，与 C 组相比，E 组在手术后第 1 天和第 3 天的疲劳发生率显着降低 （P < 0.05）。此外，与接受远端胃切除术的个体相比，接受全胃切除术的个体使用艾司氯胺酮后表现出更高程度的术后疲劳减轻。此外，与 C 组相比，E 组术后疼痛减轻，睡眠改善。两组的不良事件发生率相似。

结论： 围手术期使用艾司氯胺酮可改善腹腔镜胃根治术后 POFS，无不良反应。

试用注册： 于 2023 年 5 月 6 日在中国临床试验注册中心 （ChiCTR2300072167） 注册。

关键字： 艾司氯胺酮;胃癌;术后疲劳综合征;随机对照试验。

原文摘要

Effects of esketamine on postoperative fatigue syndrome in patients after laparoscopic resection of gastric carcinoma: a randomized controlled trial

Background: Despite the implementation of various postoperative management strategies, the prevalence of postoperative fatigue syndrome (POFS) remains considerable among individuals undergoing laparoscopic radical gastrectomy. While the N-methyl-D-aspartic acid receptor antagonist esketamine has demonstrated efficacy in enhancing sleep quality and alleviating postoperative pain, its impact on POFS remains uncertain. Consequently, the objective of this study is to ascertain whether perioperative administration of esketamine can effectively mitigate the occurrence of POFS in patients undergoing laparoscopic radical gastrectomy.

Methods: A total of 133 patients diagnosed with gastric cancer were randomly assigned to two groups, namely the control group (Group C) (n = 66) and the esketamine group (Group E) (n = 67), using a double-blind method. The Group C received standardized anesthesia, while the Group E received esketamine in addition to the standardized anesthesia. The primary outcome measure assessed was the Christensen fatigue score at 3 days after the surgical procedure, while the secondary outcomes included the disparities in postoperative fatigue, postoperative pain, sleep quality, and adverse reactions between the two groups.

Results: In the group receiving esketamine, the fatigue scores of Christensen on the third day after surgery were significantly lower compared to the Group C (estimated difference, -0.70; 95% CI, -1.37 to -0.03; P = 0.040). Additionally, there was a significant decrease in the occurrence of fatigue in the Group E compared to the Group C on the first and third days following surgery (P < 0.05). Also, compared to individuals who had distal gastrectomy, those who had entire gastrectomy demonstrated a higher degree of postoperative tiredness reduction with esketamine. Furthermore, the Group E exhibited reduced postoperative pain and improved sleep in comparison to the Group C. Both groups experienced similar rates of adverse events.

Conclusions: The use of esketamine during the perioperative period can improve POFS after laparoscopic radical gastrectomy, without adverse reactions.

Trial registration: Registered in the Chinese Clinical Trial Registry (ChiCTR2300072167) on 05/06 /2023.

Keywords: Esketamine; Gastric carcinoma; Postoperative fatigue syndrome; Randomized controlled trial.