Objective  To explore the effects of postoperative self-controlled analgesic pump containing esketamine (ESK) on psychological status and early cognitive function of elderly patients after radical surgery for colorectal cancer (CRC).

Methods  The data of elderly patients after radical CRC surgery in Jianyang People's Hospital were retrospectively collected from January 2021 to January 2024, and were divided into the control group [only using sufentanil (FEN)] and the combined group (FEN combined with ESK) according to the different medications in the self-controlled analgesic pump. The pain levels [visual analog scale (VAS) and the number of presses of the self-controlled analgesic pump], psychological state [90-item symptom self-assessment scale (SCL-90)], and early cognitive function [Montreal Cognitive Assessment Scale (MoCA)] before and after treatment were compared between the two groups. Adverse reactions during the use of self-controlled analgesic pumps were observed and recorded in both groups to assess the safety.

Results  A total of 86 patients were included in the study, with 45 in the control group and 41 in the combined group. At 1 h before the surgery, there was no statistically significant difference in the VAS scores, dimensional mental status scores and MoCA scores between the two groups (P>0.05). At 1 h (T2), 12 h (T3), 24 h (T4) and 72 h (T5) after the surgery, the VAS scores of the combined group were significantly lower than those of the control group (all P<0.05) and the times of using the analgesic pump in the combined group were  significantly lower than those in the control group (P<0.05). After 72  h of using analgesic pumps, the psychological state scores of patients in both groups in terms of somatization scores, obsessive-compulsive symptom scores, and interpersonal relationship scores decreased significantly compared with the pre-treatment period, and the score of combined group was lower than that of the control group (P<0.05). During the use of analgesic pumps, the MoCA scores of patients in both groups showed a decreasing and then a increasing trend (P<0.05), and the MoCA scores of the combined group were significantly higher than those of the control group at T4 and T5 (P<0.05). In terms of the safety, the difference in the incidence of gastrointestinal symptoms, arrhythmia, vertigo and drowsiness between the two groups was not statistically significant (P>0.05).

Conclusion  ESK postoperative self-control analgesic pump can effectively relieve the pain level, psychological state and early cognitive function of elderly patients after radical CRC surgery, and the safety is good.

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