Effects of Esketamine on Postoperative Depression in Elderly Patients Undergoing Joint Replacement

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.