Ultrasound-Guided Femoral Nerve Block with Esketamine Adjuvant for Postoperative Analgesia in Total Knee Arthroplasty-A Randomized, Double-Blind, Controlled Trial
Abstract
Objective: To evaluate the analgesic effect and complication profile of ultrasound-guided femoral nerve block (FNB) with esketamine as an adjuvant to ropivacaine in patients undergoing total knee arthroplasty (TKA).
Methods: This was a prospective, randomized, double-blind, controlled clinical trial. Sixty patients undergoing elective TKA were randomized 1:1 into Group A (n=30) and Group B (n=30). Group A received 20 mL of 0.25% ropivacaine for ultrasound-guided FNB, whereas Group B received 20 mL of 0.25% ropivacaine combined with 0.5 mg/kg esketamine for identical FNB. All patients received combined general anesthesia and FNB. Postoperative visual analogue scale (VAS) pain scores at 2, 4, 6, 8, 10, and 12 h, 24-hour sufentanil consumption, incidence of postoperative nausea and vomiting (PONV), and other adverse events were documented.
Results: Baseline characteristics including age, height, weight, ASA physical status, gender composition, and operation duration were comparable between the two groups (all P>0.05). The VAS score at 10 h postoperatively was significantly lower in Group B than in Group A (P=0.026), while no significant differences were detected at other time points (all P>0.05). Total 24-hour sufentanil consumption was significantly reduced in Group B compared with Group A (P<0.001). The incidence of PONV did not differ significantly between the two groups (P=0.467).
Conclusion: Ultrasound-guided femoral nerve block (FNB) combined with esketamine and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 30 participants or records.
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