The Effect of Intraoperative Infusion of Different Doses of Esketamine on the Quality of Recovery in Elderly Patients Undergoing Knee Arthroplasty.

Study Summary

132 elderly patients undergoing knee arthroplasty were randomized to receive intraoperative esketamine at 0.1 mg/kg/h, 0.2 mg/kg/h, or 0.3 mg/kg/h, or an equal-volume saline infusion. The primary outcome was the 40-item quality of recovery score on postoperative day 1. Secondary outcomes included quality of recovery scores on postoperative days 2 and 7, pain, insomnia, analgesic consumption, perioperative hemodynamics, recovery times, adverse events, ambulation, and hospital stay. Outcomes were assessed through postoperative day 7. Overall, the results revealed a dose-dependent improvement in early recovery, with 0.2 and 0.3 mg/kg/h producing higher quality of recovery scores on postoperative day 1 than 0.1 mg/kg/h or saline. The 0.3 mg/kg/h dose produced the greatest early benefit without increasing adverse events, although differences were no longer evident by postoperative day 7.