To observe the clinical effect of esketamine combined with hip capsule peripheral nerve block in elderly patients undergoing total hip arthroplasty. A total of 120 elderly patients who underwent total hip arthroplasty in our hospital from January 2020 to May 2021 were randomly divided into three groups, 40 cases in each group. The observation group A was treated with esketamine subanesthetic dose combined with hip capsule peripheral nerve block, the control group B was treated with esketamine subanesthetic dose combined with lumbar plexus block, and the control group C was treated with esketamine subanesthetic dose for general anesthesia. The onset time of anesthesia, duration of block, postoperative recovery time, postoperative extubation time, MAP and HR indexes before anesthesia (T0), during skin incision (T1), 30 minutes after the start of surgery (T2), and at the end of surgery (T3) were recorded in the three groups, and the VAS score and Ramsay score at 0.5 h, 2 h, 6 h, 12 h, and 24 h after surgery, as well as the incidence of postoperative adverse reactions were recorded in the three groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
120
the use of esketamine sub-anesthetic dose combined with hip capsule peripheral nerve block
Esketamine subanesthetic dose combined with lumbar plexus block was used
general anesthesia was performed with esketamine subanesthetic dose.
ChangzhouTCMH
Changzhou, Jiangsu, China
Anesthesia indicators
Add a onset time of anesthesia Outcome Measure
Time frame: onset time of anesthesia 5 minutes
Anesthesia indicators
Add a duration of block Outcome Measure
Time frame: duration of block time 350 minutes
Anesthesia indicators
Add a postoperative recovery time Outcome Measure
Time frame: postoperative recovery time 15 minutes
Anesthesia indicators
Add a postoperative extubation time Outcome Measure
Time frame: postoperative extubation time 17 minutes
Vital signs
mean arterial pressure before anesthesia (T0)
Time frame: before anesthesia (T0)
Vital signs
mean arterial pressure during skin incision (T1)
Time frame: during skin incision (T1)
Vital signs
mean arterial pressure 30 minutes after the start of surgery (T2)
Time frame: 30 minutes after the start of surgery (T2)
Vital signs
mean arterial pressure at the end of surgery (T3)
Time frame: at the end of surgery (T3) 85 minutes
Vital signs
heart rate before anesthesia (T0)
Time frame: before anesthesia (T0)
Vital signs
heart rate 30 minutes during skin incision (T1)
Time frame: during skin incision (T1)
Vital signs
heart rate after the start of surgery (T2)
Time frame: after the start of surgery (T2)
Vital signs
heart rate at the end of surgery (T3)
Time frame: at the end of surgery (T3) 78 minutes
Visual Analogue Scale
Visual Analogue Scale score (0 is no pain; 0 \~ 4 is mild pain; 4 \~ 7 is moderate pain; 7 \~ 10 is severe pain)
Time frame: 0.5hour
Visual Analogue Scale
Visual Analogue Scale score (0 is no pain; 0 \~ 4 is mild pain; 4 \~ 7 is moderate pain; 7 \~ 10 is severe pain)
Time frame: 2hour
Visual Analogue Scale
Visual Analogue Scale score (0 is no pain; 0 \~ 4 is mild pain; 4 \~ 7 is moderate pain; 7 \~ 10 is severe pain)
Time frame: 6hour
Visual Analogue Scale
Visual Analogue Scale score (0 is no pain; 0 \~ 4 is mild pain; 4 \~ 7 is moderate pain; 7 \~ 10 is severe pain)
Time frame: 12hour
Visual Analogue Scale
Visual Analogue Scale score (0 is no pain; 0 \~ 4 is mild pain; 4 \~ 7 is moderate pain; 7 \~ 10 is severe pain)
Time frame: 24hour
Ramsay sedation score
Ramsay score (range 0\~6 points, 1 point for insufficient sedation, 2\~4 points for good sedation, 5\~6 points for excessive sedation)
Time frame: 0.5hour
Ramsay sedation score
Ramsay score (range 0\~6 points, 1 point for insufficient sedation, 2\~4 points for good sedation, 5\~6 points for excessive sedation)
Time frame: 2hour
Ramsay sedation score
Ramsay score (range 0\~6 points, 1 point for insufficient sedation, 2\~4 points for good sedation, 5\~6 points for excessive sedation)
Time frame: 6hour
Ramsay sedation score
Ramsay score (range 0\~6 points, 1 point for insufficient sedation, 2\~4 points for good sedation, 5\~6 points for excessive sedation)
Time frame: 12hour
Ramsay sedation score
Ramsay score (range 0\~6 points, 1 point for insufficient sedation, 2\~4 points for good sedation, 5\~6 points for excessive sedation)
Time frame: 24hour
Adverse reactions
the incidence of postoperative delirium, nausea and vomiting, drowsiness, skin itching and other adverse reactions
Time frame: at the end of surgery 48 hours
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