Efficacy of Esketamine as an Adjuvant for Fascia Iliaca Compartment Block on Postoperative Analgesia in Elderly Patients Undergoing Total Hip Arthroplasty
DOI:
https://doi.org/10.12669/pjms.42.9.15889Keywords:
Total hip arthroplasty, Esketamine, Ropivacaine, Fascia iliac compartment block, Postoperative analgesiaAbstract
Objective: To study the effect of esketamine as an adjuvant for fascia iliaca compartment block (FICB) on postoperative analgesia in elderly patients undergoing total hip arthroplasty(THA).
Methodology: This study is a single-center prospective randomized controlled study. 60 elderly patients who underwent THA at the 904th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from August to December 2025 were randomly divided into the observation group and the control group by the random number table method. The observation group conducted FICB with 0.3 mg/kg esketamine combined with 30 mL of 0.375% ropivacaine, while the control group conducted FICB with 30 mL of 0.375% ropivacaine alone. Postoperative pain intensity, intraoperative anesthetic consumption, first press time of patient-controlled intravenous analgesia (PCIA) pump , number of effective PCIA pump presses, frequency of rescue analgesia, duration of sensory block, patient satisfaction and adverse reactions were compared between the two groups.
Results: The observation group showed a significantly lower VAS score both at rest and exercise T6(P<0.05), T12(P<0.05).Whether at rest or at exercise, comparison of the VAS score trends over time between two groups showed statistically significant differences(P<0.05). Intraoperative anesthetic consumption, number of effective PCIA pump presses and frequency of rescue analgesia within 48 hours after opreation were also significantly lower in the observation group (P < 0.05). Duration of sensory block and time for PCIA pump first press were significantly longer in the observation group (P < 0.05).
Conclusion: Esketamine used as an adjuvant in FICB is safe and effective for elderly patients undergoing THA, providing effective pain relief, prolonging postoperative analgesia duration, with few adverse reactions and high patient satisfaction.
