Author(s)

Li Mao ¹

Affiliation(s)

¹ Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China

Corresponding Author

Li Mao

ABSTRACT

This study aims to evaluate the effects of esketamine on postoperative depressive symptoms in elderly patients undergoing joint replacement surgery. Sixty elderly patients scheduled for unilateral total hip or knee replacement were included in the study and randomly divided into two groups using a random number table: the esketamine group (Group A, n=30) and the control group (Group D, n=30). Patients in Group A received intravenous infusion of 0.5 mg/kg esketamine during surgery, while those in Group D were given an equal amount of saline as a control. After surgery, they were connected to a patient-controlled analgesic pump. Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores were assessed and recorded preoperatively, 3 days postoperatively, and 7 days postoperatively. Visual Analog Scale (VAS) scores were also assessed and recorded at 1 day, 3 days, and 7 days postoperatively. Adverse reactions during and after surgery were recorded. At 3 days and 7 days postoperatively, the HAMD and HAMA scores in Group A were significantly lower than those in Group D (P<0.05). However, there was no significant difference between the two groups in terms of VAS scores or the incidence of postoperative adverse reactions. A dose of 0.5 mg/kg esketamine can effectively improve postoperative depressive and anxiety symptoms in elderly patients undergoing joint replacement surgery without increasing the incidence of postoperative adverse reactions.

KEYWORDS

Esketamine; Elderly; Joint Replacement; Depression; Anxiety

CITE THIS PAPER

Li Mao, Effects of Esketamine on Postoperative Depression in Elderly Patients Undergoing Joint Replacement. MEDS Public Health and Preventive Medicine (2025) Vol. 5: 112-117. DOI: http://dx.doi.org/10.23977/phpm.2025.050116.

REFERENCES

[1] LAN P, CHEN X, FANG Z, et al. Effects of comorbidities on pain and function after total hip arthroplasty [J]. Frontiers in Surgery, 2022,9:829303.
[2] Wang Tingting. A study on the effects of multimodal analgesia on postoperative anxiety and depression in patients undergoing knee replacement [D]. Wannan Medical College, 2020.
[3] Kamp J, Olofsen E, Henthorn TK,et al. Ketamine pharmacokinetics. Anesthesiology , 2020,133(6):1192-1212. 
[4] LUO T, DENG Z, REN Q, et al. Effects of esketamine on postoperative negative emotions and early cognitive disorders in patients undergoing non-cardiac thoracic surgery: a randomized controlled trial[J]. Journal of Clinical Anesthesia, 2024,95:111447.
[5] Tully J L, Dahlen A D, Haggarty C J, et al. Ketamine treatment for refractory anxiety: a systematic review [J]. British Journal of Clinical Pharmacology, 2022,88 (10):4412-4426.

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