To evaluate whether esketamine can relieve anxiety in patients undergoing abdominal tumor surgery.

Hamilton anxiety Scale was used to screen patients with anxiety. Only patients with score ≥ 8 were enrolled. These patients were randomly assigned to the experimental group and control group.

All patients enrolled were evaluated with Hamilton anxiety Scale, PHQ-8 scale, QoR-15 Scale and Athens Insomnia Scale. After induction, sevoflurane and remifentanil were used to maintain anesthesia. The experimental group had esketamine while the control group had normal saline. Athens Insomnia Scale was used to assess the sleep status 1, 2, 3 days after surgery and 1 month after surgery. Hamilton anxiety Scale was used to evaluate the anxiety state of the patients 3 days after surgery and 1 month after surgery. PHQ-8 scale, QoR-15 Scale were collected 3 days after surgery and 1 month after surgery.

Inclusion Criteria:

• Patients undergoing abdominal tumor surgery;
• older than 18 years old and younger than 70 years old;
• ASA grade I-III；
• Hamilton anxiety scale ≥ 8.

Exclusion Criteria:

• Having serious mental illness before surgery or on antipsychotic medication in the two weeks before screening;
• Severe organ function lesions such as heart failure (left ventricular ejection fraction <30%), myocardial infarction, kidney failure (requiring kidney replacement therapy), liver function impairment (Child-Pugh grade C), etc.
• Patients arranged to receive general anesthesia combined with epidural anesthesia patients;
• Patients who cannot communicate, read or write due to visual, auditory, language or other reasons;
• Patients allergic to ketamine;
• Patients refused to use postoperative self-controlled intravenous analgesia pump;
• Patients refused to participate in the study.