Effects of Esketamine-assisted intravenous general anesthesia in elderly patients undergoing total knee arthroplasty
Objective:To investigate effects of Esketamine-assisted intravenous general anesthesia in elderly patients undergoing total knee arthroplasty(TKA).Methods:A prospective study was conducted on 280 elderly patients with knee joint disease who underwent TKA in this hospital from June 2021 to June 2023.They were divided into study group and control group according to the random number table method,140 cases in each.The control group was treated with conventional intravenous general anesthesia(Propofol + Remifentanil + Atracurium besylate),while the study group was treated with low-dose Esketamine on the basis of that of the control group.Sufentanil was used for patient-controlled intravenous analgesia after the surgery.The dosage of intraoperative Propofol and postoperative Sufentanil,the postoperative pain[visual analogue scale(VAS)]score,the preoperative and postoperative cognitive function[Montreal cognitive assessment(MoCA)]scores,the stress response indicators[interleukin-6(IL-6),epinephrine,norepinephrine]levels,and the incidence of adverse reactions were compared between the two groups.Results:The dosages of intraoperative Propofol and postoperative Sufentanil in the study group were less than those in the control group,and the differences were statistically significant(P<0.05).The VAS scores 6,24 and 48 h after the surgery and the levels of serum norepinephrine,epinephrine and IL-6 immediately after the surgery in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The MoCA scores of the two groups after the surgery were lower than those before operation,but that of the study group was higher than that of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the study group was 5.00%(7/140),which was lower than 15.71%(22/140)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Esketamine-assisted intravenous general anesthesia for the elderly patients with TKA can improve the anesthetic effects,reduce the postoperative pain and the stress reactions,protect the postoperative cognitive function,and reduce the dosage of Propofol and Sufentanil,and reduce the incidence of adverse reactions.Moreover,it is superior to conventional intravenous general anesthesia.
Total knee arthroplastyElderlyEsketamineGeneral anesthesiaStress reactionCognitive function
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