Effect of different doses of Esketamine on analgesic efficacy in middle-aged and elderly patients undergoing knee arthroscopy
WANG Feng
LI Baogui
WEN Zuoqiang
MA Lijun
HUANG Ping
Abstract：Objective To explore the effect of different doses of Esketamine on analgesic efficacy in middle-aged and elderly patients undergoing knee arthroscopy.Methods A total of 96 patients undergoing knee arthroscopy under combined spinal-epidural anesthesia admitted from January to April 2024 were selected as the research subjects.They were divided into the blank group(n=32,conventional induction anesthesia),the L group(n=32,induction with 0.2 mg/kg Esketamine),and the H group(n=32,induction with 0.4 mg/kg Esketamine)by the random number table method.Anesthetic quality[duration of anesthesia,duration of operation,degree of lower limb motor block at 30 min after anesthesia using Bromage score],Ramsay sedation score and Visual Analogue Scale(VAS)score at 6,12,24 and 48 h after the operation were compared among the three groups.The levels of neuron-specific enolase(NSE)and central nervous system specific protein(S-100β)before the operation and at 24 h after the operation,and the adverse reactions during anesthesia were recorded.Results The duration of anesthesia and duration of operation in L group and H group were both shorter than those in the blank group,and the Bromage score was higher than that in the blank group(P<0.05).The duration of anesthesia and duration of operation in the H group were shorter than those in the L group,while the Bromage score in the H group was higher than that in the L group(P<0.05).At 6,12,24 and 48 h after the operation,the Ramsay sedation scores of the L group and the H group were higher than those of the blank group,while the VAS pain scores were lower than those of the blank group(P<0.05).The Ramsay sedation scores of the H group at 6,12 and 24 h after the operation were higher than those of the L group,while the VAS pain score was lower than that of the L group(P<0.05).At 24 h after the operation,the levels of NSE and S-100β in all three groups were higher than those before the operation(P<0.05).At 24 h after the operation,The levels of NSE and S-100β were lower in the L group and the H group than in the blank group,and lower in the H group than in the L group(P<0.05).The total incidence of adverse reactions during anesthesia was higher in the L group and the H group than in the blank group,and higher in the H group than in the L group(P<0.05).Conclusion Different doses of Esketamine could all improve the anesthetic quality of middle-aged and elderly patients undergoing knee arthroscopy,alleviate postoperative pain,and have a certain brain-protective effect.Anesthesia with 0.4 mg/kg Esketamine performed better in several indicators,but the incidence of adverse reactions during anesthesia was relatively high.
Keywords：Esketamineanesthesiaknee arthroscopic surgerymiddle-aged and elderly peopleRamsay sedation scorevisual analogue scale scoreneuron-specific enolasedrug toxicity
Publication Date：2025-12-13
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：6( 128-133 )