What question did this study set out to answer?

This research aims to evaluate how different doses of esketamine affect postoperative fatigue syndrome in patients undergoing lumbar vertebral fusion surgery.

April 1, 2026Open Access

The Effect of Esketamine on Postoperative Fatigue Syndrome in Middle-Aged and Elderly Patients Undergoing Lumbar Vertebral Body Fusion Surgery—A Retrospective Study

Key Points

This research aims to evaluate how different doses of esketamine affect postoperative fatigue syndrome in patients undergoing lumbar vertebral fusion surgery.
Analyzed clinical data of 105 patients who underwent PLIF
Divided into high-dose, low-dose esketamine and control groups
Monitored intraoperative sufentanil, heart rate, mean arterial pressure
Assessed fatigue and psychological status preoperatively and during recovery
Evaluated pain intensity using numeric rating scale
Group HS had significantly lower fatigue scores compared to Group LS and Group C (p < 0.05)
Incidence of postoperative fatigue syndrome was 46.67% in Group HS compared to 88.57% for Group LS and 92.50% for Group C (p < 0.05)
Group HS exhibited better recovery scores upon leaving the recovery room compared to other groups (p < 0.05)
Intraoperative sufentanil usage was lowest in Group HS; also lower in Group LS than Group C (p < 0.05)
Psychological distress measures (SDS, SAS) were lower in Group HS than both other groups on postoperative days 3 and 5 (p < 0.05)

Abstract

Aims/Background: Lumbar spine disease frequently occurs in middle-aged and elderly individuals, significantly affecting their physical and mental health. Posterior lumbar interbody fusion (PLIF) is widely used for treating these diseases; however, postoperative complications may lead to fatigue. Therefore, we explore the effect of different postoperative doses of esketamine on postoperative fatigue syndrome (POFS) in patients undergoing PLIF. Methods: This retrospective study analyzed the clinical data of 105 patients undergoing PLIF between June 2022 and September 2024. Patients were divided into high-dose esketamine group (Group HS, 30 cases), low-dose esketamine group (Group LS, 35 cases) and control group (Group C, 40 cases) based on the preoperative dosages of esketamine. Furthermore, intraoperative sufentanil usage, heart rate (HR) and mean arterial pressure (MAP) were assessed at different times during surgery. Recovery conditions and the length of hospitalization were compared across the three groups. Fatigue levels and psychological status, evaluated using the Christensen fatigue scale, self-rating depression scale (SDS), and self-rating anxiety scale (SAS), were assessed preoperatively and on postoperative days 3 and 5. Pain intensity was assessed using the numeric rating scale (NRS) at 30 min after awakening and on postoperative days 1 and 2. The incidence of POFS and adverse drug reactions (ADRs) was also analyzed among the three groups. Results: Compared to T0, MAP and HR scores decreased significantly across all groups from T1 to T3 (p 0.05). The incidence of POFS in Group HS was 46.67%, significantly lower than in Group LS (88.57%) and Group C (92.50%, p 0.05). Conclusion: Preoperative intravenous esketamine administration effectively prevents POFS in middle-aged and elderly patients undergoing PLIF under general anesthesia in the prone position. An esketamine dose of 0.5 mg/kg shows superior efficacy in reducing postoperative anxiety, depression, and pain levels.

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