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

作者：S Q Qu, Wenjie Zhang, Hui Zhou, Fei‐Yan Deng, Ruijuan Liu, Wenjun Yan · 发表于：BMC Anesthesiology · 年份：2025 · DOI：10.1186/s12871-025-02894-6 · 被引用次数：11 · 研究领域：Anesthesia and Pain Management、Treatment of Major Depression、Anesthesia and Sedative Agents

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). CONCLU...