Efficacy of sufentanil combined with esketamine in patient-controlled intravenous analgesia in elderly patients after hip replacement
Dai Xiaozhen
Du Anjie
Yang Qun
Luo Qian
Yang Zexue
Rao Lihao
Cheng Feng
Geng Pengcheng
Abstract：Objective To explore the efficacy of sufentanil combined with esketamine in patient-controlled intravenous analge-sia(PCIA)in elderly patients after hip replacement(HR).Methods A total of 76 elderly patients undergoing HR in Lu'an People's Hospital between October 2022 and January 2024 were enrolled in this study.According to random number table method,they were divided into the control group(n=38)and experimental group(n=38).For PCIA,the patients in the control group were given sufent-anil while those in the experimental group were given sufentanil+esketamine.The scores of visual analogue scale(VAS),pain stress factors,postoperative sleep,recovery and incidence of adverse reactions were compared between the two groups.Results The total dosage of sufentanil within 48 h after surgery,effective press times of analgesia pump,remedial analgesia rate,scores of VAS under rest and motion states at 12 h,24 h and 48 h after surgery in the experimental group were(102.96±10.59)μg,(6.85±1.52)times,5.26% (2/38),(1.85±0.32)points,(1.01±0.25)points,(0.67±0.14)points,(2.16±0.55)points,(1.59±0.39)points and(1.21±0.28)points,lower than those in the control((110.63±10.85)μg,(10.22±2.03)times,21.05% (8/38),(1.56±0.44)points,(1.28±0.31)points,(0.86±0.22)points,(2.58±0.64)points,(1.97±0.48)points,(1.67±0.36)points)and the differences were statistically significant(t=3.118,8.192,4.415,3.286,4.179,4.491,3.068,3.788,6.218,all P<0.05).The duration of effective analgesia and analgesia satis-faction were(4.38±1.12)h and(87.96±3.52)points in the experimental group,which were higher than those in the control((3.35±0.78)h,(78.97±5.32)points)and the differences were statistically significant(t=4.652,8.687,both P<0.05).At 12 h after sur-gery,levels of serum cortisol(Cor)and prostaglandin E2(PGE2)in experimental group and control group were(351.23±32.45)mmol·L-1,(104.25±12.25)ng·L-1,(396.58±38.75)mmol·L-1 and(118.36±15.89)ng·L-1,higher than those before surgery((223.45±29.63)mmol·L-1,(88.96±9.68)ng·L-1,(224.77±29.26)mmol·L-1,(87.78±9.75)ng·L-1),and the two indexes in experimental group were significantly lower than those in the control group(t=5.531,4.335,both P<0.05).The first leaving bed time,length of hospital stay,scores of insomnia severity index(ISI)at 1 d,3 d and 5 d after surgery in the experimental group were(13.26±1.52)h,(9.12±2.05)d,(12.56±2.24)points,(10.34±1.24)points and(4.58±0.35)points,lower than those in the control((19.35±1.86)h,(13.63±2.48)d,(15.22±3.21)points,(12.58±2.03)points,(5.69±0.68)points)and the differences were statistically significant(t=15.629,8.640,4.189,5.805,8.947,all P<0.05).On 1 d,3 d and 5 d after surgery,nighttime sleep time in the experimental group was longer than that in the control((4.96±0.83)h,(6.23±0.86)h,(8.03±0.45)h vs(4.12±1.01)h,(5.16±1.05)h,(7.05±0.86)h),showing statistically significant differences(t=3.961,4.560,6.224,all P<0.05).There was no significant difference in the inci-dence of adverse reactions between the experimental group and the control(15.79% (6/38)vs 26.32% (10/38),χ2=1.267,P=0.260).Conclusion The efficacy of sufentanil combined with esketamine for PCIA is significant in elderly patients after HR since it can effectively relieve pain and pain stress response,improve sleep quality and accelerate patients recovery.Meanwhile,it is of high safety.
Keywords：Elderly patientHip jointArtificial joint replacementPatient-controlled intravenous analgesiaSufentanilEsketamine
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 687-691 )