A subanesthetic dose of esketamine combined with hip peripheral nerve block has good sedative and analgesic effects in elderly patients undergoing total hip arthroplasty: A randomized-controlled trial

Abstract

Objectives: This study aims to observe the postoperative anesthetic effect of esketamine combined with hip capsule peripheral nerve block (PNB) in elderly patients undergoing total hip arthroplasty (THA).

Patients and methods: A total of 120 elderly patients (67 males, 53 females; mean age: 72.5±6.1 years; range, 60 to 89 years) who underwent THA between January 2020 and May 2021 were randomly divided into three groups including 40 patients in each group. The observation group (Group A) was treated with a subanesthetic dose of esketamine combined with hip capsule PNB; control group (Group B) was treated with a subanesthetic dose of esketamine combined with lumbar plexus block; and control group (Group C) was treated with a subanesthetic dose of esketamine for general anesthesia. The onset time of anesthesia, duration of block, postoperative recovery time, postoperative extubation time, mean arterial pressure (MAP), heart rate (HR) indexes, Visual Analog Scale (VAS) and Ramsay Sedation Scale (RSS) scores were recorded.

Results: The onset time of anesthesia, duration of block, postoperative recovery time and postoperative extubation time in Group A were significantly lower than those in Groups B and C (p<0.001). Compared to Groups B and C, the MAP was higher at T1-T3 and the HR was significantly higher at T0-T1 (p<0.05) in Group A. The VAS scores after the operation in Group A were significantly lower than those in Groups B and C (p<0.001), and the RSS scores after the operation were significantly higher in this group than in Groups B and C (p<0.001).

Conclusion: A subanesthetic dose of esketamine combined with hip capsule PNB for elderly patients undergoing THA has better postoperative analgesic effects.

Citation: Dai B, Huo Y. A subanesthetic dose of esketamine combined with hip peripheral nerve block has good sedative and analgesic effects in elderly patients undergoing total hip arthroplasty: A randomized-controlled trial. Jt Dis Relat Surg 2023;34(3):548-556. doi: 10.52312/jdrs.2023.997.

The study protocol was approved by the IRB of the Hospital of Traditional Chinese Medicine in Changzhou (date: 24.11.2021, no: 2021-LL-09 [L]). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Idea, design, data collection, writing the article: B.D.; Analisis, literature review, references: X.X.; Supervision, critical review, materials: Y.H.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

A written informed consent was obtained from each patient.

The data that support the findings of this study are available from the corresponding author upon reasonable request.