Effects of Small-Dose Esketamine on Postoperative Analgaesia and Sleep Quality in Patients with Total Hip Replacement.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP – November 01, 2024
Source: PubMed
Summary
A promising alternative to traditional pain management after hip replacement has emerged: small doses of esketamine provide better pain relief with fewer complications than standard fentanyl treatment. Patients receiving esketamine needed pain medication later and required fewer doses overall. While sleep quality remained similar between treatments, esketamine patients avoided common issues like urinary retention that affected fentanyl users.
Abstract
To determine the effect of esketamine in patient-controlled analgaesia after hip replacement on postoperative pain and improve sleep quality in patients. Randomised double-blind study. Place and Duration of the Study: Department of Anaesthesiology, The First Affiliated Hospital of Guangxi Medical University, from March 2021 to May 2022. The research enrolled 72 patients who were subjected to unilateral complete hip replacement surgery utilising jointly administered universal and peripheral nerve-obstructing anaesthetics. A randomised numeric table method was used to allocate patients to either the F-D group (fentanyl combined with dexmedetomidine, n = 34) or the Es-D group (esketamine combined with dexmedetomidine, n = 38). The key outcome indicators included the time to first administration of rescue analgaesic, the dose of rescue analgaesics, and postoperative sleep quality. Baseline characteristics did not differ between the two groups. The time until postoperative analgaesic rescue medication was considerably shorter for those in the Es-D group (p <0.05). In addition, the Es-D group used significantly fewer rescue analgaesics (p = 0.01). The PSQI score and unpleasant responses (PONV, dizziness, nightmare) did not significantly differ between the two groups (p <0.05). Nevertheless, urine retention occurred in four patients in group F-D but not in group Es-D (p <0.05). Esketamine produced better analgaesia than fentanyl with fewer side effects after surgery. However, no improvement was observed in sleep quality. Arthroplasty, Postoperative analgaesia, Esketamine, Sleep quality, Patient-controlled analgaesia.