全髋关节置换术后使用艾司氯胺酮进行患者自控静脉镇痛的有效性和安全性：一项随机对照试验。

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

作者信息

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

机构信息

Department of Anesthesiology, Guizhou Hospital The First Affiliated Hospital of Sun Yat-sen University, GuiYang, China.

Department of Anesthesiology, Guian Hospital The Affiliated Hospital of Guizhou Medical University, GuiYang, China.

出版信息

BMC Anesthesiol. 2025 Jan 20;25(1):31. doi: 10.1186/s12871-025-02894-6.

DOI:10.1186/s12871-025-02894-6

PMID:39833672

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11744849/

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).

摘要

目的

评估依托咪酯用于全髋关节置换术后患者自控静脉镇痛的有效性和安全性。

方法

135例全髋关节置换术患者被随机分为三组治疗组之一：依托咪酯组、舒芬太尼组或连续髂筋膜室阻滞（FICB）组。主要终点是术后静息和活动时的视觉模拟量表（VAS）疼痛评分。次要终点包括术前1天和术后7天的自评焦虑量表（SAS）和自评抑郁量表（SDS）评分、患者和外科医生的满意度、术后1个月和3个月的Harris功能评分、不良反应发生率。

结果

术后48小时，依托咪酯组和FICB组静息和活动时的VAS疼痛评分显著低于舒芬太尼组（P < 0.05）。依托咪酯组患者的满意度高于舒芬太尼组和FICB组（P = 0.014）。依托咪酯组和FICB组外科医生的满意度高于舒芬太尼组（P = 0.002）。术后第7天，依托咪酯组的SAS评分和SDS评分显著低于舒芬太尼组和FICB组（P < 0.05）。与舒芬太尼组相比，依托咪酯组和FICB组术后恶心呕吐、头晕及总不良反应发生率较低（P < 0.05）。