Effect of subanesthetic dose of esketamine on postoperative rehabilitation in elderly patients undergoing hip arthroplasty

Abstract Objective To investigate the effect of postoperative analgesia with subanesthetic dose of esketamine on rehabilitation of elderly patients undergoing hip arthroplasty. Methods 150 patients, ASA physical statusⅠ～Ⅱ, aged ≥ 60 years, no limitation in gender, BMI18 ~ 25 kg/cm2, who underwent selective total hip arthroplasty, according to random number table method, esketamine group (group A) and sufentanil group (group B) were randomized, 75 patients in each group. The two groups received general anesthesia method.At the end of the operation, PCIA was connected for analgesia. In group A, esketamine 2.5mg/kg was mixed with normal saline to 100ml. In group B, sufentanil 2.5ug/kg was mixed with normal saline to 100ml. Record the VAS scores after operation. Record the first ambulation time, ambulation distance and PCA compression times after operation. The incidence of postoperative adverse reactions such as drowsiness, dizziness, nausea and vomiting, multilingual were recorded. ELISA was used to detect IL-6 and CRP in the morning, 24 hours and 72 hours after operation. The hospital Anxiety and Depression Scale (HAD) score and Harris score at 3 days, 1 week and 1 month after operation were followed up. Results There was no significant difference in VAS score and PCA compression times(P > 0.05), but the incidence of nausea, vomiting and dizziness in group B was higher than that in group A(P < 0.05). Compared with group B, the levels of IL-6 and CRP in group A at 24h and 72h after operation were significantly decreased (P < 0.05). Postoperative ambulation time and ambulation distance in group A were better than those in group B(P < 0.05). The HAD score of group A was lower than that of group B at 3 days and 1 week after operation.(P < 0.05). However, there was no significant difference between the two groups at 1 month after operation (P > 0.05). The Harris score of group A was higher than that of group B at 3 days, 1 week and 1 month after operation(P < 0.05). Conclusions Esketamine can reduce short-term postoperative anxiety and depression, relieve postoperative pain and stress response, shorten bed rest time after total hip replacement, and accelerate postoperative recovery.