Ultrasound-Guided Femoral Nerve Block with Esketamine Adjuvant for Postoperative Analgesia in Total Knee Arthroplasty-A Randomized, Double-Blind, Controlled Trial.

Study Summary

60 patients undergoing elective total knee arthroplasty (TKA) were randomized to receive ultrasound-guided femoral nerve block (FNB) with 20 mL of 0.25% ropivacaine alone or 20 mL of 0.25% ropivacaine plus 0.5 mg/kg esketamine. The primary outcome of interest was postoperative pain measured using the visual analogue scale (VAS). Secondary outcomes of interest included 24-hour sufentanil consumption, postoperative nausea and vomiting (PONV), and other adverse events. Outcomes were assessed up to 24 hours postoperatively. Overall, the results of the study revealed that adding esketamine reduced VAS pain at 10 hours and decreased 24-hour sufentanil consumption, without significantly affecting PONV. These findings suggested that perineural esketamine may provide an opioid-sparing analgesic benefit when added to ropivacaine for FNB after TKA.