Effects of Small-Dose Esketamine on Postoperative Analgaesia and Sleep Quality in Patients with Total Hip Replacement.
Abstract
<h4>Objective</h4>To determine the effect of esketamine in patient-controlled analgaesia after hip replacement on postoperative pain and improve sleep quality in patients.<h4>Study design</h4>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.<h4>Methodology</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>Esketamine produced better analgaesia than fentanyl with fewer side effects after surgery. However, no improvement was observed in sleep quality.<h4>Key words</h4>Arthroplasty, Postoperative analgaesia, Esketamine, Sleep quality, Patient-controlled analgaesia.
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