{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T07:03:05Z","timestamp":1767769385330,"version":"3.48.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"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. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to explore the effects of preoperative nutritional support combined with esketamine on recovery and postoperative pain management in elderly patients undergoing thoracoscopic radical resection for lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 165 elderly patients with lung cancer who underwent thoracoscopic radical resection at our hospital between June 2021 and March 2023 were enrolled and divided into a study group (SG,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200985) and a control group (CG,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200980). The SG received patient-controlled analgesia with esketamine, sufentanil, dexamethasone, and dexmedetomidine, while the CG received sufentanil, dexamethasone, and dexmedetomidine. The SG received nutritional support both pre- and postoperatively, whereas the CG received it only postoperatively. We compared resting and coughing visual analog scale (VAS) scores; Ramsay sedation scores at 6, 12, 24, and 48\u2005h post-surgery; the number of analgesic pump compressions and drug consumption within 48\u2005h; adverse reactions; recovery indicators; immune function; nutritional status; and quality of life between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the CG, the SG demonstrated significantly lower VAS scores at rest and during cough and higher Ramsay sedation scores at 6, 12, 24, and 48\u2005h postoperatively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The SG also required fewer analgesic pump compressions and lower analgesic drug dosages within 48\u2005h (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The incidence of adverse reactions within 48\u2005h was lower in the SG (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Postoperative recovery indicators, including time to first exhaust, first defecation, and hospitalization, were significantly shorter in the SG (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Furthermore, the SG showed significantly elevated levels of Immunoglobulin G (IgG), IgM, IgA, albumin (Alb), transferrin (TRF), and prealbumin (PAB) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), as well as higher scores across all 36-Item Short Form Health Survey (SF-36) dimensions (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative nutritional support combined with esketamine was associated with reduced pain, improved postoperative recovery indicators, better maintained immune function and nutritional status, and a higher quality of life in elderly patients after thoracoscopic radical resection of lung cancer.<\/jats:p>\n                  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