Ginsenoside Rb1 (GRb1), one of the principle active ingredients of Panax ginseng, exerts multiple pharmacological activities to fight fatigue. In the present study, we investigate the anti-fatigue effect of GRb1 on postoperative fatigue syndrome (POFS) in a rat model induced by major small intestinal resection. GRb1 (10 mg/kg) was administrated intraperitoneally once daily for 1, 3, 7, and 10 d from the operation day. Antifatigue effect was assessed by grasping test and biochemical parameters in blood or skeletal muscle were determined by autoanalyzer or commercially available kits. Transmission electron microscope was applied to observe the ultra microstructure of skeletal muscles. The results revealed that GRb1 significantly enhanced rat maximum grip strength with POFS. Similarly, negative alterations in biochemical parameters (lactic acid, hepatic glycogen, muscle glycogen and malondialdehyde) of POFS rats were improved by GRb1. In addition, GRb1 also increased the activity of lactate dehydrogenase and superoxide dismutase in POFS. No significant differences of levels of blood urea nitrogen and ultra microstructure of skeletal muscles were found between the POFS and GRb1 treatment rats. The potent anti-fatigue effect of GRb1 on POFS might be achieved through improvement of energy metabolism and suppression of skeletal muscle oxidative stress.Key words ginsenoside Rb1; postoperative fatigue syndrome; energy metabolism; oxidative stress; animal experiment Ginseng, the dried root of Panax ginseng C. A. MEYER (Araliaceae), has been used as a tonic to treat various disorders in Chinese traditional medicine. It is considered the king of herbs since the earliest Chinese pharmaceutical monograph "Shen Nong Ben Cao Jing." 1) Currently, ginseng is used worldwide as a popular herbal medicine, especially in China, Korea and Japan. Ginsenosides are thought to be the main active ingredients of ginseng with multiple pharmacological activities including anti-aging, anti-carcinogenic, anti-oxidation, antiinflammation, and anti-fatigue.2-6) Modern science has identified more than 50 kinds of ginsenosides. Ginsenoside Rb1 (GRb1), one of the ginsenosides, belongs to the protopanaxadiol group of steroidal saponins. Accumulating evidence indicates that GRb1 exerts a protective effect against stress in various conditions. [7][8][9] Currently, one of the major tasks of surgery is to enhance the recovery after operation. Postoperative fatigue syndrome (POFS) is a common complication after surgery, especially major abdominal and cardiac procedures. 10) For affected patients, POFS manifests itself as a feeling of malaise, lethargy, loss of energy, concentration difficulties and debilitating fatigue. It can persist for up to one month after abdominal operations and gradually resolves in as long as 3 months after uncomplicated gastrointestinal surgery.11-13) Patients who suffer from POFS have a prolonged recovery to normal daily life. In addition, POFS increases health-service costs, burdens patients themselves, their families, hospitals...