The efficacy and safety of patient-controlled intravenous analgesia with esketamine after total hip arthroplasty: a randomized controlled trial.

IF 2.3 3区医学 Q2 ANESTHESIOLOGY BMC Anesthesiology Pub Date : 2025-01-20 DOI:10.1186/s12871-025-02894-6

Song Qu, Wen-Jie Zhang, Hai-Jiao Zhou, Fei Deng, Rui-Juan Liu, Wen-Jun Yan

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Abstract

Purpose: To evaluate the efficacy and safety of esketamine-based patient-controlled intravenous analgesia following total hip arthroplasty.

Methods: A total of 135 total hip arthroplasty patients were randomly assigned to one of the three treatment groups: esketamine, sufentanil or continuous fascia iliaca compartment block (FICB) group. The primary endpoint was the postoperative visual analogue scale (VAS) pain scores at rest and on movement. Secondary endpoints included preoperative 1-day and postoperative 7-day Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores, the satisfaction of patients and surgeons, postoperative 1-month and 3-month Harris function scores, the incidence of adverse reactions.

Results: At 48 h post-surgery, the VAS pain scores in the esketamine and FICB groups at rest and on movement were significantly lower than those in the sufentanil group (P < 0.05). The satisfaction of patients in the esketamine group was higher than that in the sufentanil and FICB groups (P = 0.014). The satisfaction of surgeons in the esketamine and FICB groups was higher than that in the sufentanil group (P = 0.002). At postoperative day 7, the SAS scores and SDS scores in the esketamine group were significantly lower than those in the sufentanil and FICB groups (P < 0.05). Compared with the sufentanil group, the postoperative nausea and vomiting, dizziness and total adverse reactions in the esketamine group and FICB group were lower (P < 0.05).

Conclusion: Patient-controlled intravenous analgesia with esketamine has the potential to provide good postoperative analgesia for total hip arthroplasty patients, reduce the incidence of adverse reactions after the operation, improve the satisfaction of patients and surgeons, and significantly improve patients' postoperative mood.

Trial registration: ChiCTR2300069632 ( https://www.chictr.org.cn/ ) (March 22th, 2023).

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全髋关节置换术后患者控制静脉注射艾氯胺酮镇痛的有效性和安全性：一项随机对照试验。

目的：评价艾氯胺酮为基础的全髋关节置换术后静脉自控镇痛的疗效和安全性。方法：135例全髋关节置换术患者随机分为艾氯胺酮组、舒芬太尼组和连续筋膜髂腔室阻滞组（FICB）。主要终点是术后休息和运动时的视觉模拟评分（VAS）疼痛评分。次要终点包括术前1天和术后7天焦虑自评量表（SAS）和抑郁自评量表（SDS）评分、患者和外科医生满意度、术后1个月和3个月Harris功能评分、不良反应发生率。结果：术后48 h，艾氯胺酮组和FICB组休息和运动时VAS疼痛评分均显著低于舒芬太尼组(P)。艾氯胺酮患者控制静脉镇痛有可能为全髋关节置换术患者提供良好的术后镇痛，降低术后不良反应的发生率，提高患者和外科医生的满意度，显著改善患者术后情绪。试验注册：ChiCTR2300069632 (https://www.chictr.org.cn/)（2023年3月22日）。

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来源期刊

BMC Anesthesiology ANESTHESIOLOGY-

CiteScore

3.50

自引率

4.50%

发文量

349

审稿时长

>12 weeks

期刊介绍： BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.