{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:22:00Z","timestamp":1779124920819,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> To investigate the effect of a single sub-anesthetic dose of ketamine on postoperative anxiety, depression, and inflammatory factors in patients with colorectal cancer.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A total of 104 patients undergoing selective colorectal surgery in our hospital from Jan 2015 to Oct 2017 were included and randomly assigned (1:1:1:1) into a 0.1\u00a0mg\u00a0kg<jats:sup>\u22121<\/jats:sup> ketamine group (K1 group), 0.2\u00a0mg\u00a0kg<jats:sup>\u22121<\/jats:sup> ketamine group (K2 group), 0.3\u00a0mg\u00a0kg<jats:sup>\u22121<\/jats:sup> ketamine group (K3 group), or control group (C group). Corresponding doses of ketamine were given intravenously in the K groups (K1, K2, and K3 groups) 5\u00a0min before operation, and the same amount of normal saline was given in the C group. The intravenous analgesia program was identical in the four groups. The patients\u2019 emotional reactions (anxiety and depression) were assessed by the Hospital Anxiety and Depression Scale (HAD), the quality of postoperative recovery was evaluated by the Quality of Recovery-40 (QoR-40) questionnaire, and the levels of IL-6, IL-8, and TNF-\u03b1 in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA) on the day before operation and within 24, 48, and 72\u00a0h post-operation respectively. Pain was estimated by the visual analog scale (VAS), and sedation was assessed with Ramsay score 30\u00a0min after extubation. The time points of anesthetic end and extubation were recorded. The complications during anesthesia and recovery such as cough and agitation 30\u00a0min after extubation were recorded.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The anxiety score (HAD-A) and depression score (HAD-D) of the K3 group were significantly lower than those of the C group post-operation (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The QoR-40 score of the K3 group was significantly higher than that of the C group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The serum levels of IL-6, IL-8, and TNF-\u03b1 in the K3 group were significantly lower than those in the C group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05 and <jats:italic>p<\/jats:italic> &amp;lt; 0.01). There were no significant differences in HAD-A, HAD-D, and QoR-40 scores or serum levels of IL-6, IL-8, and TNF-\u03b1 between the K1 and K2 groups and the C group. There were no significant differences in VAS pain score or Ramsay sedation score among the four groups 30\u00a0min after extubation. There were no significant differences in extubation time, postoperative cough, emergence agitation, or delirium among the four groups. Dizziness, nausea, vomiting, diplopia, or other adverse reactions were not found 30\u00a0min after extubation.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> A single sub-anesthetic dose (0.3\u00a0mg\u00a0kg<jats:sup>\u22121<\/jats:sup>) of ketamine can significantly improve the postoperative anxiety and depression of colorectal cancer patients and reduce the levels of IL-6, IL-8, and TNF-\u03b1.<\/jats:p>","DOI":"10.3389\/fphar.2022.818822","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T11:19:09Z","timestamp":1649675949000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Effects of a Single Sub-Anesthetic Dose of Ketamine on Postoperative Emotional Responses and Inflammatory Factors in Colorectal Cancer Patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Qin","family":"Ren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Hua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingjun","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianrong","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"81","DOI":"10.21037\/jgo.2017.01.12","article-title":"Depresion, Anxiety, and Health Related Quality of Life Among Colorectal Cancer Survivors","volume":"8","author":"Aminisani","year":"2017","journal-title":"Gastrointest. Oncol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"292","DOI":"10.9738\/INTSURG-D-12-00009.1","article-title":"Surgical Stress Response after Colorectal Resection","volume":"98","author":"Andersson","year":"2013","journal-title":"Int. Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1080\/13548506.2015.1125006","article-title":"Depression and Anxiety Symptoms Following Cancer Diagnosis: a Cross-Sectional Study","volume":"21","author":"Cardoso","year":"2016","journal-title":"Psychol. Health Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.psychres.2018.08.078","article-title":"Rapid Inflammation Modulation and Antidepressant Efficacy of Low-Dose Ketamine Infusion in Treatment-Resistant Depressiona Randomized, Double Blind Control Study","author":"Chen","year":"2018","journal-title":"Psychiatry Res."},{"key":"B5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.14715\/cmb\/2017.63.5.18","article-title":"Determination of IL-6, TNF-\u03b1 and VEGF Levels in the Serums of Patients with Colorectal Cancer","volume":"63","author":"Coskun","year":"2017","journal-title":"Cell Mol Biol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.lfs.2016.02.094","article-title":"Regulatory Effects of Anesthetics on Nitric Oxide","volume":"151","author":"Fan","year":"2016","journal-title":"Life Sci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1001\/archsurg.135.3.291","article-title":"Is Interleukin 6 an Early Marker of Injury Severity Following Major Trauma in Humans?","volume":"135","author":"Gebhard","year":"2000","journal-title":"Arch. Surg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12893-016-0120-y","article-title":"Depression and Postoperative Complications: an Overview","volume":"16","author":"Ghoneim","year":"2016","journal-title":"BMC Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.pnpbp.2015.11.012","article-title":"Innate and Adaptive Immunity in the Development of Depression: an Update on Current Knowledge and Technological Advances","author":"Haapakoski","year":"2016","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.2174\/1570159X113119990043","article-title":"Ketamine as Antidepressant? Current State and Future Perspectives","volume":"12","author":"Hasselmann","year":"2014","journal-title":"Curr. Neuropharmacol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1177\/2040622315579059","article-title":"Ketamine and Other N- Methyl-D-Aspartate Receptor Antagonists in the Treatment of Depression: a Perspective Review","volume":"6","author":"Iadarola","year":"2015","journal-title":"Ther. Adv. Chronic Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/j.pnpbp.2011.03.019","article-title":"Rapid Decrease in Depressive Symptoms with an N-Methyl-D-Aspartate Antagonist in ECT-Resistant Major Depression","volume":"35","author":"Ibrahim","year":"2011","journal-title":"Prog. Neuropsyehopharmacol Biol. Psychiatry"},{"key":"B13","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.4088\/JCP.09m05327blu","article-title":"Rapid Resolution of Suicidal Ideation after a Single Infusion of an N-Methyl-D-Aspartate Antagonist in Patients with Treatment-Resistant Major Depressive Disorder","volume":"71","author":"Ibrahim","year":"2010","journal-title":"J. Clin. Psychiatry"},{"key":"B14","doi-asserted-by":"publisher","first-page":"345","DOI":"10.4103\/0259-1162.186590","article-title":"Comparison of the Effects of Four Subdoses of Dextroketamine to Reduce Pain during Posterior Brachial Plexus Block: A Randomized Double Blind Study","volume":"11","author":"Imbellon","year":"2017","journal-title":"Anesth. Essays Res."},{"key":"B15","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1111\/bdi.12277","article-title":"A Single Infusion of Ketamine Improves Depression Scores in Patients with Anxious Bipolar Depression","volume":"17","author":"Ionescu","year":"2015","journal-title":"Bipolar Bipolar Disord."},{"key":"B16","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1097\/00000542-200008000-00032","article-title":"Analgesic Mechanisms of Ketamine in the Presence and Absence of Peripheral Inflammation","volume":"93","author":"Kawamata","year":"2000","journal-title":"Anesthesiology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1126\/science.1190287","article-title":"mTOR-Dependent Synapse Formation- Undedies the Rapid Antidepressant Effects of NMDA Antagonists","volume":"329","author":"Li","year":"2010","journal-title":"Science"},{"key":"B18","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.nicl.2018.09.001","article-title":"Ketamine Influences the Locus Coeruleus Norepinephrine Network, with a Dependencyon Norepinephrine Transporter Genotype \u2013 a Placebo Controlled fMRI Study","volume":"20","author":"Liebe","year":"2018","journal-title":"NeuroImage: Clin."},{"key":"B19","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/j.biopsych.2011.09.030","article-title":"Brain-derived Neurotrophic Factor Val66Met Allele Impairs Basal and Ketamine-Stimulated Synaptogenesis in Pre-frontal Cortex","volume":"71","author":"Liu","year":"2012","journal-title":"Biol. Psychiatry"},{"key":"B20","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1097\/ALN.0b013e3181e90914","article-title":"Intraoperative Ketamine Reduces Perioperative Opiate Consumption in Opiate-dependent Patients with Chronic Back Pain Undergoing Back Surgery","volume":"113","author":"Loftus","year":"2010","journal-title":"Anesthesiology"},{"key":"B21","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s12029-010-9132-5","article-title":"Depression and Anxiety in Colorectal Cancer Patients","volume":"41","author":"Medeiros","year":"2010","journal-title":"J. Gastrointest. Cancer"},{"key":"B22","doi-asserted-by":"publisher","first-page":"101668","DOI":"10.1016\/j.ejon.2019.09.009","article-title":"Supportive Care Needs, Quality of Life and Psychological Morbidity of Advanced Colorectal Cancer Patients","volume":"43","author":"Miniotti","year":"2019","journal-title":"Eur. J. Oncol. Nurs."},{"key":"B23","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1111\/cns.12099","article-title":"Ketamine Pharmacology:An Update (Pharmacodynamics and Molecular Aspects, Recent Findings)","volume":"19","author":"Mion","year":"2013","journal-title":"CNS Neurosci. Ther."},{"key":"B24","doi-asserted-by":"publisher","first-page":"481","DOI":"10.23736\/S0375-9393.17.12115-2","article-title":"Preventative Effect of Ketamine on post-surgical Hyperalgesia Induced at a Body Part Remote from the Surgical Site","volume":"84","author":"Moon","year":"2018","journal-title":"Minerva Anestesiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3389\/fimmu.2018.00291","article-title":"T Cell Phenotype and T Cell Receptor Repertoire in Patients with Major Depressive Disorder","author":"Patas","year":"2018","journal-title":"FrontImmunol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.pharmthera.2019.02.017","article-title":"Fast-acting Antidepressant Activity of Ketamine: Highlights on Brain Serotonin, Glutamate, and GABA Neurotransmission in Preclinical Studies","volume":"199","author":"Pham","year":"2019","journal-title":"Pharmacol. Ther."},{"key":"B27","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1097\/AAP.0000000000000806","article-title":"Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists","volume":"43","author":"Schwenk","year":"2018","journal-title":"Reg. Anesth. Pain Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1590\/1806-9282.65.3.361","article-title":"Increased Levels of Plasma IL\u00b71b and BDNF Can Predict Resistant Depression Patients","volume":"65","author":"Uint","year":"2019","journal-title":"Rev. Assoc. Med. Bras"},{"key":"B29","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.neuroscience.2016.11.029","article-title":"Posttraumatic Administration of a Sub-anesthetic Dose of Ketamine Exerts Neuroprotection via Attenuating Inflammation and Autophagy","volume":"343","author":"Wang","year":"2017","journal-title":"Neuroscience"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2666","DOI":"10.1038\/npp.2013.176","article-title":"Subanesthetic Doses of Ketamine Transiently Decrease Serotonin Transporter Activity: A PET Study in Conscious Monkeys","volume":"38","author":"Yamamoto","year":"2013","journal-title":"Neuropsychopharmacology"},{"key":"B31","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s12264-010-0323-7","article-title":"Behavioral Animal Models of Depression","volume":"26","author":"Yan","year":"2010","journal-title":"Neurosci. Bull."},{"key":"B32","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.biopsych.2014.06.021","article-title":"Serum Interleukin-6 Is a Predictive Biomarker for Ketamine\u2019s Antidepressant Effect in Treatment-Resistant Patients with Major Depression","volume":"77","author":"Yang","year":"2015","journal-title":"Biol. Psychiatry"},{"key":"B33","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1038\/nature17998","article-title":"NMDAR Inhibition-independent Antidepressant Actions of Ketamine Metabolites","volume":"533","author":"Zanos","year":"2016","journal-title":"Nature"},{"key":"B34","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1007\/s12035-014-8798-2","article-title":"Loss of Phenotype of Parvalbumin Interneurons in Rat Prefrontal Cortex Contributes to the Antidepressant and Propsychotic Effects of Ketamine","volume":"51","author":"Zhou","year":"2015","journal-title":"Mol. Neurobiol."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2022.818822\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T11:19:12Z","timestamp":1649675952000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2022.818822\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":34,"alternative-id":["10.3389\/fphar.2022.818822"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2022.818822","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,5]]},"article-number":"818822"}}