Postoperative pain
Conditions
Interventions
Experimental Group (esketamine):First operation: After venous access was established, the patient underwent neuraxial anesthesia (spinal anesthesia combined with epidural anesthesia) plus saphenous ne
Control Group (normal saline):First operation and second operation: An equal volume of 0.9% sodium chloride injection was used instead of esketamine intraoperatively and postoperatively. The PCIA form
Sponsors
The Affiliated Hospital of Qingdao University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Age 18-75 years old; 2. ASA classification Grade I-III; 3. To be scheduled for staged bilateral total knee arthroplasty under spinal anesthesia on an elective basis within one year; 4. Patients voluntarily participate in this study and sign the informed consent form.
Exclusion criteria
Exclusion criteria: 1. Known hypersensitivity to esketamine, ropivacaine, or other local anesthetics. 2. Absolute or relative contraindications to neuraxial anesthesia (e.g., coagulopathy, infection at the puncture site, intracranial hypertension, etc.). 3. History of long-term opioid use (>3 months) or opioid use disorder. 4. Severe hepatic insufficiency (e.g., alanine transaminase/aspartate transaminase > 2×upper limit of normal, elevated bilirubin, prothrombin time 180 mmHg and/or diastolic blood pressure > 110 mmHg). 6. History of severe psychiatric disorders (e.g., schizophrenia, bipolar disorder) or use of monoamine oxidase inhibitors (MAOIs) within the past 1 month. 7. History of open surgery or severe trauma on the ipsilateral knee. 8. Moderate to severe chronic pain not originating from the knee before surgery (resting NRS score > 6); or concurrent neuropathic pain other than knee arthritis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Area under the curve of mechanical pain threshold at 6, 12, 24, 48, and 72 hours after the second operation.; | — |
Secondary
| Measure | Time frame |
|---|---|
| Area under the curve of mechanical pain threshold at 6, 12, 24, 48, and 72 hours after the first operation.;Incidence of mechanical allodynia at 24 hours after surgery;Mechanical pain threshold before the second operation;Incidence of central sensitization;NRS pain score;Cumulative postoperative opioid consumption;Extra rescue analgesic dosage;Incidence of rebound pain;Quality of Recovery-15 (QoR-15) score;Sleep quality;Time to first patient-controlled analgesia (PCA) bolus;Incidence of chronic postsurgical pain (CPSP);Hospitalization cost;Postoperative length of hospital stay; | — |
Countries
China
Contacts
Public ContactWei Feng
The Affiliated Hospital of Qingdao University
Outcome results
None listed