Chronic postsurgical pain
Conditions
Interventions
Intervention group:The drug (esketamine 0.2 mg/kg diluted to 10 ml in saline) was injected intravenously before the induction of general anesthesia, followed by the usual anesthesia induction protocol
Sponsors
Nanjing Drum Tower Hospital
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age>= 65 years old, gender is not limited 2. American Society of Anesthesiologists (ASA) Class I- III; 3. Patients with an admission diagnosis of osteoarthritis; 4. Patients undergoing elective unilateral primary total knee arthroplasty; 5. Preoperative Pittsburgh Sleep Quality Index (PSQI) score > 7; 6. Electronic medical record system entrants; 7. Subjects agreed to participate in this study and signed an informed consent form.
Exclusion criteria
Exclusion criteria: 1. Patients with severe hypertension (resting systolic/diastolic blood pressure over 180/100 mmHg), intracranial occupations, or intracranial hypertension; 2. Patients with recent brain injury, cerebral infarction, or cerebral hemorrhage; those with severe organ dysfunction; patients with glaucoma or hyperthyroidism; patients with a previous history of angina pectoris, myocardial infarction, or heart failure; and patients with coagulation disorders; 3. Patients with a previous history of chronic pain; 4. Combined history of peripheral neuropathy and psychosis; 5. Patients with cognitive dysfunction; 6. Those with severe hearing or speech impairments who are unable to cooperate with the evaluation; 7. Those taking oral central nervous system-acting medications that interfere with perioperative pain assessment; 8. Those who are allergic to known test drugs; 9. Missing case information entered into the electronic case system; 10. Those who were uncooperative and unable to communicate; 11. Those with a history of previous knee surgery or recovery from anesthesia for an unusual procedure; 12. Recent participation in other clinical trials.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain score at rest at 90 days postoperatively;Pain scores during activity at 90 days postoperatively;Incidence of chronic postsurgical pain at 90 days postoperatively; | — |
Secondary
| Measure | Time frame |
|---|---|
| Pittsburgh sleep quality index (PSQI);Vital signs monitoring: systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), pulse oximetry (SpO2), bispectral index (BIS), pulse pressure variability (PPV);Routine examinations and test results during the perioperative period;Blood gas values;Richards—CampbeIl sleep Questionnaire ;Types and doses of intraoperative and postoperative analgesic drugs;Test drug-related adverse reactions within 1 day postoperatively;Incidence, pain scores, and nature of acute pain in resting and active subjects 1 to 3 days after surgery;Post-operative down time;Postoperative drainage tube removal time;Postoperative complications during hospitalization;Clavien-Dindo grading;Intraoperative hypotension, hypertension, number and dose of vasoactive drugs used during operation;New cardiac and cerebrovascular complications during hospitalization;postoperative hospital stay;90 days after surgery pain, nature of pain, type and dose of rescue analgesic drugs used; | — |
Countries
China
Contacts
Public ContactMa Zhengliang
Nanjing Drum Tower Hospital
Outcome results
None listed