Impaired intrinsic capacity
Conditions
Interventions
S-ketamine group:The S-ketamine group will receive an intravenous infusion of S-ketamine (40 mg S-ketamine plus 0.9% saline to 20 ml, 2.0 mg/ml) at a rate of 0.1 ml/kg/h (0.2 mg/kg/h) over a period of
Placebo group:In the placebo group, participants will be administered an intravenous infusion of 0.9% saline following the same rate and schedule as the S-ketamine group. Post-surgery, the PCIA device
Sponsors
The Affiliated Hospital of Qingdao University
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Inclusion criteria
Inclusion criteria: (1) age = 60 years old ; (2) American Society of Anesthesiologists (ASA) class I–III; (3) selective total knee arthroplasty (TKA) under intraspinal anesthesia; (4) patients with impaired intrinsic ability, defined as those with the comprehensive intrinsic capacity score =8 points.
Exclusion criteria
Exclusion criteria: (1) failure of intraspinal anesthesia; (2) previous ipsilateral knee joint surgical history; (3) severe cardiocerebrovascular disease (e.g., hypertension grade III, serious valvular disease, chronic heart failure, severe arrhythmia, ischemic heart disease, stroke); (4) severe liver or kidney disease (e.g., Child–Pugh score C, creatinine clearance rate < 35 ml/min); (5) contraindications for the use of Esketamine (such as severe refractory hypertension, pulmonary heart disease, hyperthyroidism, epilepsy, increased intraocular pressure, increased intracranial pressure, history of cerebrovascular accidents, allergy, and a family history of malignant hyperthermia); (6) patients at high risk for malignant hyperthermia (such as strabismus and scoliosis); (7) patients who are unable to cooperate or sign the informed consent form.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The quality of recovery score at 24 hours ; | — |
Secondary
| Measure | Time frame |
|---|---|
| The QoR-15 scores at 48 and 72 hours postoperatively;The baseline preoperative pain scores at rest and exercise, as well as the postoperative pain scores at rest and exercise from days 1 to 3 at 8:00-10:00 and 16:00-18:00;The equivalent oral morphine consumption of rescue analgesics;Sleep quality on postoperative days 1 to 3 ;Depression scores on postoperative days 1 to 3 ;The Barthel Index at baseline preoperatively and at discharge;The time to meet discharge criteria ; | — |
Countries
China
Contacts
Public ContactYang Zhao
The Affiliated Hospital of Qingdao University
Outcome results
None listed