Objective To investigate the effect of esketamine combined with sufentanil in patient-controlled intravenous analgesia (PCIA) on fatigue and immune function of patients after thoracoscopic radical resection of lung cancer.

Methods A total of 120 patients undergoing thoracoscopic radical resection of lung cancer in Xuzhou Central Hospital from October 2021 to August 2022 were randomly divided into two groups: group E (PCIA with esketamine 1.5 mg/kg and sufentanil 1.0 μg/kg, n=60) and group C (PCIA with sufentanil 2.0 μg/kg, n=60). Before anesthesia, 24 h, 48 h and 72 h after surgery, fatigue scale model (Christensen score) and identity-consequence fatigue scale (ICFS) were used to evaluate patients' fatigue. Numerical rating scale (NRS) was used to evaluate analgesia efficiency. Peripheral blood T cytokines (CD3⁺, CD4⁺, CD4⁺/CD8⁺) and complement C3 and C4 were measured. The adverse reactions were recorded.

Results Compared with group C, the scores of Christensen and ICFS in group E were lower at 24 h and 48 h after operation (P < 0.05). Compared with group C, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, C3 and C4 in group E were higher at 24 h, 48 h, 72 h after operation (P < 0.05). The incidences of nausea, vomiting and pruritus in group E were lower than those in group C (P < 0.05). There was no significant difference in NRS between the two groups.

Conclusion For patients undergoing thoracoscopic radical resection of lung cancer, esketamine combined with sufentanil in PCIA can relieve postoperative fatigue, reduce the adverse reactions, and improve T cell immune function.