Impact on analgesic efficacy and safety of esketamine as an adductor canal block adjuvant in knee arthroplasty
10.3760/cma.j.cn114015-20240322-00188
- VernacularTitle:艾司氯胺酮作为收肌管阻滞佐剂对膝关节置换术镇痛效果和安全性的影响
- Author:
Yan ZHANG
1
;
Yichao CAI
1
;
Na CAO
1
;
Huiru YANG
1
;
Xinghua BIAN
1
;
Kan LI
1
Author Information
1. 张家口市第一医院麻醉科，张家口 075061
- Publication Type:Journal Article
- Keywords:
Knee joint, artificial;
Analgesia;
Safety;
Adjuvants, pharmaceutic;
Esketamine
- From:
Adverse Drug Reactions Journal
2024;26(11):672-676
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact on analgesic efficacy and safety of esketamine as an adductor canal block adjuvant in knee arthroplasty.Methods:The study was a prospective, single center, randomized controlled trial. The subjects were patients who received knee arthroplasty in Zhangjiakou First hospital from October 2021 to October 2023. The patients were randomly divided into trial group and control group using a random number table method. The patients in the both groups received general anesthesia and postoperative patient-controlled intravenous analgesia (PCIA). The patients in the trial group were injected with 0.375% ropivacaine combined with esmketamine, while those in the control group were only injected with 0.375% ropivacaine. The postoperative vital signs, quadriceps femoris muscle strength, resting and dynamic visual analogue scale (VAS) pain score, use of PCIA, and incidence of postoperative adverse reactions in patients between the 2 groups were compared.Results:A total of 120 patients were included in this study, with 60 cases in each group. There were no significant differences in heart rate, mean arterial pressure, respiratory rate, and body temperature in patients between the trial group and the control group at 24 and 48 hours after operation (all P>0.05). There were no significant differences in quadriceps femoris muscle strength at 12, 24 and 48 hours after operation (all P>0.05). At rest, the VAS pain score at 12 hours after operation in the trial group was lower than that in the control group [(2.89±0.49) points vs. (3.36±0.23) points], the difference was statistically significant ( P<0.05). In the active state, the VAS scores at 12 and 24 hours after operation in the trial group were lower than those in the control group [(3.78±0.41) points vs. (4.11±0.45) points, (3.79±0.56) points vs. (4.19±0.69) points], the differences were statistically significant (all P<0.05). The number of times of PCIA compression 24 hours after operation in the experimental group was less than that in the control group [(5.35±1.03) times vs. (7.89±1.34) times], and the difference was statistically significant ( P<0.05), the sensory block time in the experimental group was longer than that in the control group [(488.26±57.75) min vs. (92.26±65.15) min], and the difference was statistically significant ( P<0.05). There were no significant differences in total incidence of adverse reactions including nausea, vomiting, urinary retention, dizziness, drowsiness, delirium and hallucination in patients between the 2 groups within 1 week after operation (all P>0.05). Conclusion:Esketamine as an adjuvant of ropivacaine for adductor block can alleviate the pain level of patients undergoing knee arthroplasty, and it has good safety.
