Evidence map›Paper›PMID 40951888›Full record

ArticleJournal of medical biochemistry2025

Esketamine modulates postoperative biochemical markers of oxidative stress, inflammation, and immune dysregulation in laparoscopic colorectal cancer surgery.

Peng Chen, Kun Qian, Kairun Zhu, Lu Xiaoqing, Liu Dajin

2 registry-linked trialsAbstract read
In one paragraph

Article in Journal of medical biochemistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07576517 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Perioperative Use of Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery: a 2×2 Factorial Trial

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2030Enrolled1,160ConditionsOlder Patients, Surgery, Dexmedetomidine, EsketamineArmsDex-Esk, Placebo, Active tDCS, Sham tDCS
NCT07576543 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Long-term Follow-up of Perioperative Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2031Enrolled1,160ConditionsOlder Patients, Surgery, Dexmedetomidine, EsketamineArmsDex-Esk, Placebo, Active tDCS, Sham tDCS
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Peng ChenShanghai Jiao Tong University School of Medicine, Suzhou Kowloon Hospital, Department of Anesthesiology, Suzhou, China.
Kun QianThe Affiliated Huai'an Hospital of Xuzhou Medical University, Department of Joint Surgery, Huai'an, China.
Kairun ZhuThe Affiliated Huai'an Hospital of Xuzhou Medical University, Department of Joint Surgery, Huai'an, China.
Lu XiaoqingThe Affiliated Huai'an Hospital of Xuzhou Medical University, Department of Joint Surgery, Huai'an, China.
Liu DajinThe Affiliated Huai'an Hospital of Xuzhou Medical University, Department of Joint Surgery, Huai'an, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Laparoscopic colorectal cancer surgery, while minimally invasive, induces systemic oxidative stress, inflammation, and immune dysfunction through surgical trauma and anesthesia-related stress. Esketamine, an NMDA receptor antagonist with antioxidant and anti-inflammatory properties, may mitigate these biochemical perturbations. This study evaluated esketamine's effects on serum biomarkers of oxidative stress (glutathione, catalase, malondialdehyde, superoxide dismutase), inflammatory mediators (TNF-a, CRP IL-6), and T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer resection. Methods: In this randomized controlled trial, 150 stage I-II colorectal cancer patients were allocated to esketamine (0.25 mg/kg bolus + 0.12 mg/kg/h infusion) or control (saline) groups during standardized anesthesia. Preand postoperative serum levels of oxidative stress markers (GSH, CAT, MDA, SOD), inflammatory cytokines (TNF-a, CRP IL-6), and immune cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+ ratio) were quantified via ELISA and flow cytometry. Statistical analysis compared intergroup differences using t-tests and chi-square tests. Results: Postoperatively, the esketamine group exhibited significantly attenuated oxidative stress, with higher GSH (72.43± 6.63 vs. 60 .1 6± 5.57 mg/mL, P < 0.05), CAT (92.56± 8.31 vs. 82.81 ± 7.75 U/mL), and SOD (84.53± 8.02 vs. 69 .93± 7.05 nU/mL), alongside lower MDA (6.41± 0.52 vs. 9.52± 0.63 mmol/L). Pro-inflammatory cytokines were reduced (TNF-a: 4 0 .32 ± 4.84 vs. 54.37± 5.80 pg/mL; IL-6: 50.83± 5.05 vs. 82 .38± 8.46 pg/mL, P < 0.05). Immune function preservation was evident through elevated CD3+ (4 5 .1 8 ± 5 .0 1 % vs. 37 .05 ± 4.92% ) and CD4+ T cells (26.51 ±2.76% vs. 19.78± 2.09%), with a balanced CD4+/CD8+ ratio (1.12± 0.12 vs. 0.72± 0.09). Conclusions: Esketamine-based anesthesia significantly ameliorates postoperative oxidative damage, suppresses inflammatory cytokine release, and preserves cellular immune homeostasis, as evidenced by targeted biochemical and immunological analyses. These findings highlight esketamine's role in modulating perioperative biochemical pathways, potentially enhancing recovery in colorectal cancer surgery.

Indexed as

antioxidant enzymescolorectal surgeryesketamineimmune biomarkersinflammatory cytokinesperioperative biochemistry

Identifiers

PMID40951888
PMCPMC12433307

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.