Effect of Esketamine Combined with Sufentanil-Based Patient-Controlled Intravenous Analgesia on Postoperative Pain in Elderly Total Hip Arthroplasty Patients: A Three-Arm Randomized Trial DOI

Yu-Hang Shou,

Jian-Sheng Luo Shou,

Xianjie Zhang

и другие.

International journal of anesthesia and clinical medicine., Год журнала: 2025, Номер 13(1), С. 37 - 45

Опубликована: Май 9, 2025

Background: Total hip arthroplasty (THA) is a common procedure for end-stage disorders, yet postoperative pain management remains challenging due to opioid-related complications, particularly in elderly patients vulnerable respiratory depression and delirium. Multimodal analgesia strategies are increasingly prioritized mitigate these risks. Esketamine, an NMDA receptor antagonist with opioid-sparing anti-neuroinflammatory properties, shows promise enhancing while reducing adverse effects. Preliminary studies suggest its efficacy lowering delirium risk, though optimal dosing THA populations unclear. This study aimed evaluate the analgesic safety of different dosages esketamine combined sufen-tanil patient-controlled intravenous (PCIA) undergoing total arthroplasty. Methods: In this randomized, prospective, double-blind trial, 120 were randomly divided into three groups: control group (Group S, <i>n</i> = 40) received sufentanil 2 μg/kg; experimental SE1 (<i>n</i> 1.5 μg/kg 1 mg/kg; SE2 mg/kg. Primary outcomes included resting movement-associated Visual Analogue Scale (VAS) scores at 4, 8, 12, 24, 48 h postoperatively. Secondary encompassed Ramsay Sedation (RSS) scores, Quality Recovery-15 (QoR-15) h, time first walk, number requiring remedial analgesia, events (nausea/vomiting, hallucinations, pruritus, delirium, dizziness). Results: The groups demonstrated significantly superior compared S across all outcomes. Resting VAS lower both esketamine-combined points (4, h; <I>P</I> < 0.05). levels (Ramsay scores) dose-dependently enhanced esketamine. Group exhibited higher sedation than 24 (<I>P</I> 0.01) QoR-15 Groups 0.001). Time walk was shorter No significant differences observed requirement rescue between groups. Adverse showed reduction (POD) incidence nausea/vomiting 0.05) no dizziness, or pruritus. Conclusion: randomized controlled trial that reduced-dose improved recovery THA.

Язык: Английский

Does Esketamine Peripartum Intervention Reduce the Risk of Postpartum Depression? A Systematic Review and Meta-Analysis of Obstetric Anesthesia and Analgesic Approaches DOI
Yiran Li, Xingyu Hu, Xintong Chen

и другие.

Опубликована: Янв. 1, 2025

Язык: Английский

Процитировано

0
Effect of Esketamine Combined with Sufentanil-Based Patient-Controlled Intravenous Analgesia on Postoperative Pain in Elderly Total Hip Arthroplasty Patients: A Three-Arm Randomized Trial DOI

Yu-Hang Shou,

Jian-Sheng Luo Shou,

Xianjie Zhang

и другие.

International journal of anesthesia and clinical medicine., Год журнала: 2025, Номер 13(1), С. 37 - 45

Опубликована: Май 9, 2025

Background: Total hip arthroplasty (THA) is a common procedure for end-stage disorders, yet postoperative pain management remains challenging due to opioid-related complications, particularly in elderly patients vulnerable respiratory depression and delirium. Multimodal analgesia strategies are increasingly prioritized mitigate these risks. Esketamine, an NMDA receptor antagonist with opioid-sparing anti-neuroinflammatory properties, shows promise enhancing while reducing adverse effects. Preliminary studies suggest its efficacy lowering delirium risk, though optimal dosing THA populations unclear. This study aimed evaluate the analgesic safety of different dosages esketamine combined sufen-tanil patient-controlled intravenous (PCIA) undergoing total arthroplasty. Methods: In this randomized, prospective, double-blind trial, 120 were randomly divided into three groups: control group (Group S, <i>n</i> = 40) received sufentanil 2 μg/kg; experimental SE1 (<i>n</i> 1.5 μg/kg 1 mg/kg; SE2 mg/kg. Primary outcomes included resting movement-associated Visual Analogue Scale (VAS) scores at 4, 8, 12, 24, 48 h postoperatively. Secondary encompassed Ramsay Sedation (RSS) scores, Quality Recovery-15 (QoR-15) h, time first walk, number requiring remedial analgesia, events (nausea/vomiting, hallucinations, pruritus, delirium, dizziness). Results: The groups demonstrated significantly superior compared S across all outcomes. Resting VAS lower both esketamine-combined points (4, h; <I>P</I> < 0.05). levels (Ramsay scores) dose-dependently enhanced esketamine. Group exhibited higher sedation than 24 (<I>P</I> 0.01) QoR-15 Groups 0.001). Time walk was shorter No significant differences observed requirement rescue between groups. Adverse showed reduction (POD) incidence nausea/vomiting 0.05) no dizziness, or pruritus. Conclusion: randomized controlled trial that reduced-dose improved recovery THA.

Язык: Английский

Процитировано

0