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Patients were randomly assigned to Group C (control group) who received sufentanil 2 ug\/kg, and Group E (experimental group) who received sufentanil 1.5 ug\/kg\u2009+\u2009esketamine 1\u00a0mg\/kg, with 30 patients in each group. All patients underwent total intravenous anesthesia during the surgery and were connected to a patient-controlled intravenous analgesia (PCIA) pump after surgery. The primary outcome was the evaluation of pain at 4, 24, 48\u00a0h after surgery which was evaluated by NRS scores. In secondary outcomes, inflammation was assessed by measuring IL-6 levels using ELISA. The postoperative delirium and the occurrence of adverse reactions were observed on the 1st and 3rd day after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The NRS scores at 4, 24, and 48\u00a0h after surgery in the experimental group [(4.53\u2009\u00b1\u20091.22), (3.46\u2009\u00b1\u20090.73), (1.37\u2009\u00b1\u20090.99)] were lower than that in the control group [(5.23\u2009\u00b1\u20091.16), (4.46\u2009\u00b1\u20090.77), (2.13\u2009\u00b1\u20090.78)] (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). The concentration of serum IL-6 in the experimental group at 24 and 48\u00a0h after operation [(15.96\u2009\u00b1\u20094.65), (11.8\u2009\u00b1\u20093.24)] were lower than that in the control group [(23.07\u2009\u00b1\u20094.86), (15.41\u2009\u00b1\u20094.01)] (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05); the incidence of postoperative delirium in the experimental group was less than that in the control group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05); there was no significant difference in the incidence of postoperative nausea and vomiting between the two groups (\n                      <jats:italic>P\u2009&gt;<\/jats:italic>\n                      \u20090.05), and neither group had nightmares or delirium.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Esketamine may enhance postoperative pain management compare with sufentanil, and esketamine has anti-inflammatory effects that reduce the incidence of postoperative delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Full name of the registry: Chinese Clinical Trial Registry. Trial registration number: ChiCTR2300072374. Date of registration:2023\/06\/12<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-024-02424-w","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T01:02:37Z","timestamp":1706749357000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Effect of esketamine on postoperative analgesia and postoperative delirium in elderly patients undergoing gastrointestinal surgery"],"prefix":"10.1186","volume":"24","author":[{"given":"Jing","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TingTing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,1]]},"reference":[{"issue":"1","key":"2424_CR1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4097\/kja.d.18.00073.1","volume":"72","author":"ST Oh","year":"2019","unstructured":"Oh ST, Park JY. 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