Effect of different modes of administration of esketamine combined with supraclavicular brachial plexus block on the incidence of rebound pain after upper limb fracture surgery: study protocol for a single-centre, double-blinded, randomised controlled trial DOI Creative Commons
Wencai Jiang, Yanhua Peng,

Xuemeng Chen

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(12), P. e088177 - e088177

Published: Dec. 1, 2024

Background Supraclavicular brachial plexus block (SCB) is a common regional analgesic technique for upper limb fracture surgery, but it often leads to rebound pain. Our primary aim determine whether different administration methods of esketamine can reduce pain in patients undergoing SCB surgery. Methods/design This study designed as single-centre, double-blinded, prospective, randomised controlled trial. Patients who plan use tourniquet, aged 18–60 years, with body mass index 18–30 kg/m 2 and an American Society Anaesthesiologists classification I–III will be into three groups after providing written informed consent: group N (perineural esketamine/ropivacaine); V (intravenous esketamine/perineural ropivacaine); C ropivacaine). The outcome the percentage experiencing within 24 hours postoperatively. Secondary outcomes include Numeric Rating Scale (NRS) score pain, onset (since performing SCB), cumulative area under curve NRS severity scores through 48 postsurgery, postoperative opioid consumption at postoperatively, duration sensory blockade, motor blockade adverse reactions events. followed-up Discussions protocol describes design trial evaluate effect modes combined on incidence results may help identify most effective managing Ethics dissemination has been approved by Committee Deyang People’s Hospital (2023-03-010-K01). It was registered Chinese Clinical Trials Registry August 2023. We intend publish peer-reviewed journal. Trial registration number ChiCTR2300075083.

Language: Английский

S-Ketamine Reduces the Risk of Rebound Pain in Patients Following Total Knee Arthroplasty: A Randomized Controlled Trial DOI Creative Commons
Qun Li, Shaoqi Tian, Lei Zhang

et al.

Drug Design Development and Therapy, Journal Year: 2025, Volume and Issue: Volume 19, P. 2315 - 2327

Published: March 1, 2025

Investigating the effectiveness of S-ketamine in reducing rebound pain (RP) following total knee arthroplasty. This study was a randomized, double-blind, placebo-controlled trial involving 356 adult patients undergoing Patient enrollment occurred between April and October 2023, with in-person follow-up assessments conducted from admission to 3 days post-surgery. Participants were randomly assigned group (n = 178) placebo 178). In group, participants received continuous intraoperative infusion at dose 0.30 mg/(kg·h) completion spinal anesthesia until beginning joint cavity closure, whereas 0.9% saline same volume duration. The primary outcome incidence RP within 12 hours Secondary outcomes included 24 hours, time onset, first rescue analgesia, scores, opioid consumption, clinical outcomes, harms. observed 21.3% compared 34.8% post-surgery (adjusted RR, 0.62; 95% CI, 0.44 0.88; P 0.008). onset significantly delayed (unadjusted HR, 0.60; 0.41 0.009). numerical rating scale during activity physical therapy lower than (day 1 AM: unadjusted difference, -1; -1 0; 0.011; day PM: 0.003; therapy: -2; -2 < 0.001). quality recovery score higher 5; 5 satisfaction 1; effectively reduces risk delays its Additionally, can reduce early levels, enhance quality, improve patient satisfaction.

Language: Английский

Citations

0
Rebound Pain After Regional Anaesthesia DOI Creative Commons
Frances Fallon, Mohd Shazrul Ramly, Aneurin Moorthy

et al.

Medicina, Journal Year: 2025, Volume and Issue: 61(5), P. 790 - 790

Published: April 24, 2025

The last decade of anaesthesia practice worldwide has seen considerable advancements in the field regional with new equipment, techniques, and drug developments. With these advancements, gained momentum, more patients benefit from it. Here, we review rebound pain after anaesthesia, a common yet poorly understood phenomenon that all anaesthesiologists should be familiar order to recognise, manage, and, where possible, prevent

Language: Английский

Citations

0
Opioid-Free Anesthesia with Esketamine Combined with Iliac Fascia Block in Elderly Patients Undergoing Hip Surgery DOI Creative Commons

L.F. Luo,

Rui Xiao, Jinpeng Zhang

et al.

Drug Design Development and Therapy, Journal Year: 2025, Volume and Issue: Volume 19, P. 3337 - 3349

Published: April 1, 2025

Most patients with hip fractures are elderly people relatively high risks of cardiovascular and cerebrovascular accidents. Esketamine has little effect on haemodynamics an exact analgesic effect, which is beneficial for intolerance to surgery anaesthesia. Therefore, we conducted this study compare the efficacy safety esketamine those opioids in who underwent fractures. Seventy-two were included study, but data from only 68 analysed. Patients randomly assigned either EKT group (esketamine combined iliac fascia block) or OP (opioids block). was used anaesthesia induction maintenance group, sufentanil remifentanil group. The primary endpoint area under curve numeric rating scale (AUCNRS). AUCNRS significantly lower than that (6.6±3.6 vs 9.5±3.0, P =0.001). postoperative (NRS) scores pain number rescue analgesia (all <0.05). mean blood pressure greater after incidence nausea vomiting (PONV) higher (P =0.033). Elderly receiving esketamine-based opioid-free had more stable hemodynamics, better analgesia, reduced PONV compared undergoing opioid-balanced trial registered at Chinese Clinical Trial Registry September 1, 2023 (identifier: ChiCTR2300075324).

Language: Английский

Citations

0
Perspective Chapter: Analgesic Use of Esketamine DOI
Ferdi Gülaştı

IntechOpen eBooks, Journal Year: 2025, Volume and Issue: unknown

Published: May 28, 2025

Esketamine is ketamine’s left enantiomer. It alternatively referred to as (S)-(+)-ketamine or (S)-ketamine. Experiments investigating the analgesic properties of esketamine were commenced upon its discovery. Esketamine, which has begun be used a different option due undesirable effects opioids, can in perioperative pain control and subanesthetic doses for chronic pain. Esketamine’s are commonly accepted 2–4 times potent racemic ketamine. Though esketamine’s psychomimetic appear related inhibition N-methyl-D-aspartate (NMDA) receptor, use not free risk, with mental effects. Nevertheless, it likely produce less cholinergic inhibition. Following discovery ketamine 1962, efforts made 1990s find therapeutic treatment depression. In 2019, Food Drug Administration (FDA) approved treatment-resistant Interest uses an drug increased alongside FDA approval new indications.

Language: Английский

Citations

0
Effect of two concentrations of ropivacaine on rebound pain after retreat of iliac fascia block in patients undergoing total knee arthroplasty：a prospective, double-blind randomized controlled trial DOI Creative Commons
Qin Qin, Zhenfeng Huang, Xinyi Wang

et al.

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 11, 2024

Abstract Objective: The aim of this research was to evaluate the effect two different local anesthetic concentrations on rebound pain following Fascial Iliac Compartment Block (FICB) retreat in patients undergoing total knee arthroplasty (TKA). Method: 48 unilateral TKA under elective general anesthesia were randomly divided into groups (n=24): 0.1% ropivacaine group (Group A) and 0.3% B). Before anesthesia, underwent a single ultrasound guided- FICB above inguinal ligament, with 40 mL or ropivacaine; all perioperative multimodal analgesia. The first outcomes are incidence degree postoperative pain; secondary remedial analgesia rate within 48h postoperatively, opioid consumption from 0-24 h 24-48 NRS scores muscle strength at rest exercise 24h intravenous serum interleukin-6 (IL-6) tumor necrosis factor α(TNF-α) before surgery 24 after surgery. Results: In A, the lower (P<0.01), milder (P<0.01). (P<0.05); (P<0.01); score while higher There no statistically significant difference IL-6 TNF-α surgery, Conclusion: resolution low-concentration lower, more suitable for patients.

Language: Английский

Citations

0
Effect of different modes of administration of esketamine combined with supraclavicular brachial plexus block on the incidence of rebound pain after upper limb fracture surgery: study protocol for a single-centre, double-blinded, randomised controlled trial DOI Creative Commons
Wencai Jiang, Yanhua Peng,

Xuemeng Chen

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(12), P. e088177 - e088177

Published: Dec. 1, 2024

Background Supraclavicular brachial plexus block (SCB) is a common regional analgesic technique for upper limb fracture surgery, but it often leads to rebound pain. Our primary aim determine whether different administration methods of esketamine can reduce pain in patients undergoing SCB surgery. Methods/design This study designed as single-centre, double-blinded, prospective, randomised controlled trial. Patients who plan use tourniquet, aged 18–60 years, with body mass index 18–30 kg/m 2 and an American Society Anaesthesiologists classification I–III will be into three groups after providing written informed consent: group N (perineural esketamine/ropivacaine); V (intravenous esketamine/perineural ropivacaine); C ropivacaine). The outcome the percentage experiencing within 24 hours postoperatively. Secondary outcomes include Numeric Rating Scale (NRS) score pain, onset (since performing SCB), cumulative area under curve NRS severity scores through 48 postsurgery, postoperative opioid consumption at postoperatively, duration sensory blockade, motor blockade adverse reactions events. followed-up Discussions protocol describes design trial evaluate effect modes combined on incidence results may help identify most effective managing Ethics dissemination has been approved by Committee Deyang People’s Hospital (2023-03-010-K01). It was registered Chinese Clinical Trials Registry August 2023. We intend publish peer-reviewed journal. Trial registration number ChiCTR2300075083.

Language: Английский

Citations

0