Effect of Intraoperative Subanesthetic-Dose Esketamine on Postoperative Hydromorphone Consumption After Total Hip Arthroplasty: A Randomized Double-Blind Placebo-Controlled Trial
- 1Department of Anesthesiology
Abstract
Mengna Liu,1,* Yao Ning,2,* 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*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 [email protected] 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 [email protected]: 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
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BibTeX
@article{liu2026effect,
title = {{Effect of Intraoperative Subanesthetic-Dose Esketamine on Postoperative Hydromorphone Consumption After Total Hip Arthroplasty: A Randomized Double-Blind Placebo-Controlled Trial}},
author = {Liu M and Ning Y and Zhao H and Liu Z and Zhang Y and Ji Q and Gao D and Hui K and Zhang L},
journal = {Journal of Pain Research},
year = {2026},
month = nov,
url = {https://www.dovepress.com/effect-of-intraoperative-subanesthetic-dose-esketamine-on-postoperativ-peer-reviewed-fulltext-article-JPR},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effect of Intraoperative Subanesthetic-Dose Esketamine on Postoperative Hydromorphone Consumption After Total Hip Arthroplasty: A Randomized Double-Blind Placebo-Controlled Trial
AU - Liu M
AU - Ning Y
AU - Zhao H
AU - Liu Z
AU - Zhang Y
AU - Ji Q
AU - Gao D
AU - Hui K
AU - Zhang L
PY - 2026
DA - 2026/11/01
JO - Journal of Pain Research
UR - https://www.dovepress.com/effect-of-intraoperative-subanesthetic-dose-esketamine-on-postoperativ-peer-reviewed-fulltext-article-JPR
AB - Mengna Liu,1,* Yao Ning,2,* 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*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 [email protected] 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 [email protected]: 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
SN - 1178-7090
ER -