{
  "abstract": "Mengna Liu,1,&ast; Yao Ning,2,&ast; Haishu Zhao,2 Zhi Liu,2 Yue Zhang,1 Qing Ji,2 Dapeng Gao,2 Kangli Hui,2 Lidong Zhang11Department of Anesthesiology, Jinling Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, 210002, People’s Republic of China; 2Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lidong Zhang, Department of Anesthesiology, Jinling Clinical Medical College, Nanjing Medical University, No. 305, Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86-13813830315, Email ldzhang1968@163.com Kangli Hui, Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 305, Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86-15951899306, Email m15951899306@163.comBackground: This randomized, double-blind, placebo-controlled trial evaluated whether intraoperative subanesthetic-dose esketamine reduces postoperative opioid consumption and improves early recovery outcomes after total hip arthroplasty (THA).Methods: A total of 128 patients was randomized to receive esketamine (Group E, n = 64) or saline (Group C, n = 64). Group E received an intravenous esketamine bolus of 0.25 mg/kg 5 minutes before skin incision, followed by a 0.25 mg/kg/h infusion until skin closure. Group C received an equivalent volume of normal saline using the same regimen. Postoperative analgesia was provided by patient-controlled intravenous analgesia with hydromorphone. The primary outcome was the cumulative hydromorphone consumption during the first 24 h after surgery. Secondary outcomes included 48-h hydromorphone consumption, Numeric Rating Scale (NRS) pain scores, quality of recovery (QoR-15), Athens Insomnia Scale (AIS), mood, and adverse events. Postoperative sleep disturbance (PSD) was assessed as an exploratory outcome.Results: The first 24-h hydromorphone consumption was significantly lower in Group E than in Group C (2.24 [2.08– 2.51] vs 3.20 [2.88– 3.40] mg, P < 0.001). Cumulative hydromorphone consumption over the first 48 h was also lower in Group E (4.40 [4.16– 4.82] vs 5.92 [5.30– 6.23] mg, P < 0.001). Group E had lower NRS scores at 6 and 24 h. On postoperative day 1, Group E exhibited higher QoR-15 scores and lower AIS scores (P < 0.05), and the incidence of PSD was significantly lower in Group E than in Group C (26.6% vs 54.7%, P = 0.001). Adverse event rates did not differ significantly between groups (P > 0.05).Conclusion: Intraoperative subanesthetic-dose esketamine reduced the first 24-h hydromorphone consumption after THA. Findings for the secondary outcomes are exploratory and require confirmation in future studies.Trial Registration: ChiCTR2600116506.Keywords: esketamine, total hip arthroplasty, opioid consumption, postoperative recovery, sleep quality",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Liu M"
    },
    {
      "affs": [
        0
      ],
      "name": "Ning Y"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhao H"
    },
    {
      "affs": [
        0
      ],
      "name": "Liu Z"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhang Y"
    },
    {
      "affs": [
        0
      ],
      "name": "Ji Q"
    },
    {
      "affs": [
        0
      ],
      "name": "Gao D"
    },
    {
      "affs": [
        0
      ],
      "name": "Hui K"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhang L"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fnyv78gh0deja.bib",
  "cited_by": 0,
  "doi": null,
  "fulltext_url": "https://www.dovepress.com/effect-of-intraoperative-subanesthetic-dose-esketamine-on-postoperativ-peer-reviewed-fulltext-article-JPR",
  "id": "fnyv78gh0deja",
  "issns": [
    "1178-7090"
  ],
  "landing_url": "https://www.dovepress.com/effect-of-intraoperative-subanesthetic-dose-esketamine-on-postoperativ-peer-reviewed-fulltext-article-JPR",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R5-920"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-01",
  "publisher": "Dove Medical Press",
  "ris": "https://research.draconitic.com/paper/fnyv78gh0deja.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T14:20:53Z",
      "native_id": "04898fd6b9ba428c896c37464033af5c",
      "source": "doaj",
      "url": "https://www.dovepress.com/effect-of-intraoperative-subanesthetic-dose-esketamine-on-postoperativ-peer-reviewed-fulltext-article-JPR"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:R5-920",
      "subfield": "general"
    }
  ],
  "title": "Effect of Intraoperative Subanesthetic-Dose Esketamine on Postoperative Hydromorphone Consumption After Total Hip Arthroplasty: A Randomized Double-Blind Placebo-Controlled Trial",
  "title_text": "Effect of Intraoperative Subanesthetic-Dose Esketamine on Postoperative Hydromorphone Consumption After Total Hip Arthroplasty: A Randomized Double-Blind Placebo-Controlled Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T14:20:55Z",
  "url": "https://research.draconitic.com/paper/fnyv78gh0deja",
  "venue": "Journal of Pain Research",
  "versions": []
}