Effects of Esketamine on Postoperative Hospital Anxiety and Depression Scale Scores in Patients Undergoing Laparoscopic Radical Resection for Colorectal Cancer.

Key Takeaways for GI Nurses

• Adjunctive intravenous esketamine—given at induction and continued via patient-controlled intravenous analgesia (PCIA)—was associated with significantly lower postoperative anxiety and depression scores (HADS-A and HADS-D) on postoperative days 1 and 3 in patients undergoing laparoscopic colorectal cancer resection.
• Patients receiving esketamine also had reduced 24-hour interleukin-6 (IL-6) levels, suggesting a potential attenuation of the postoperative inflammatory response, and reported higher satisfaction scores compared to standard PCIA alone.
• While this study focuses on colorectal surgery rather than direct endoscopic procedures, the findings are relevant to GI nurses caring for perioperative and periprocedural patients, particularly those managing PCIA, monitoring psychological recovery, or working in units performing complex GI oncology surgeries.
• Esketamine's dual analgesic and mood-modulating properties may offer a multimodal strategy worth discussing with anesthesia and surgical teams for patients at high risk of postoperative anxiety or depressive symptoms.

Clinical Relevance

Postoperative anxiety and depression are underrecognized but clinically significant issues in patients recovering from major GI surgery, including laparoscopic colorectal cancer resections. These psychological sequelae can affect pain perception, mobility, sleep quality, and overall recovery trajectory—factors that GI and perioperative nurses are uniquely positioned to monitor and support. This study's use of the validated Hospital Anxiety and Depression Scale (HADS) as a primary outcome underscores a growing recognition that psychological recovery deserves the same rigor of measurement as physical outcomes in surgical oncology populations.

For nurses managing PCIA pumps and postoperative pain regimens, the addition of esketamine represents a pharmacologic strategy that may extend beyond analgesia into mood stabilization. Esketamine, an NMDA receptor antagonist, has established antidepressant properties in other clinical contexts, and this study extends that rationale into the perioperative surgical setting. Nurses should be aware that patients receiving esketamine-based regimens may exhibit different sedation, dissociation, or emergence profiles compared to conventional opioid-based PCIA, warranting attentive postoperative monitoring, particularly around level of consciousness—one of the secondary outcomes assessed in this trial.

From an operational standpoint, the observed reduction in IL-6 and improved patient satisfaction may translate into smoother recovery courses, potentially influencing discharge readiness and patient-reported experience metrics. As enhanced recovery after surgery (ERAS) protocols increasingly emphasize multimodal analgesia and psychological well-being, GI nursing teams should stay informed about emerging adjuncts like esketamine and be prepared to incorporate updated monitoring parameters, patient education, and interdisciplinary communication with anesthesia providers into standard perioperative care pathways.

Bottom Line

For GI nurses involved in perioperative care of colorectal cancer surgery patients, this study suggests that incorporating esketamine into anesthesia induction and PCIA regimens may meaningfully reduce early postoperative anxiety and depression scores while improving patient satisfaction—reinforcing the value of multimodal approaches that address both physical and psychological recovery in the immediate postoperative period.