Trial reportDrug design, development and therapy2025
Esketamine as an Adjuvant to Ropivacaine in Genicular Nerve and IPACK Blocks for Total Knee Arthroplasty: A Double-Blind Randomized Trial.
Trial report in Drug design, development and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- The Optimal Dose of Butorphanol Combined with Ropivacaine for Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Fracture Surgery: A Randomized, Double-Blind, Controlled Clinical Trial.Drug design, development and therapy · 2026Trial
- Ultrasound-Guided Femoral Nerve Block with Esketamine Adjuvant for Postoperative Analgesia in Total Knee Arthroplasty-A Randomized, Double-Blind, Controlled Trial.Drug design, development and therapy · 2026Trial
- Analgesic Efficacy of Continuous Bupivacaine Infusion versus Liposomal Bupivacaine in Parasacral Ischial Plane Block After Total Knee Arthroplasty: An Open-Label, Randomized, Controlled, Non-Inferiority Study.Drug design, development and therapy · 2026Trial
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Chronic postsurgical pain (CPSP) following total knee arthroplasty (TKA) affects up to 44% of patients and markedly impairs recovery and quality of life. Although regional anesthesia is integral to multimodal analgesia, its preventive effect on CPSP remains limited. Esketamine, a potent N-methyl-D-aspartate receptor antagonist with analgesic and neuroprotective properties, may enhance local anesthetic efficacy and reduce the development of chronic pain. Patients and Methods: In this prospective, randomized, double-blind trial, 367 patients undergoing unilateral TKA under general anesthesia with peripheral nerve blocks were allocated to three groups: CTRL (normal saline), ROP (0.5% ropivacaine), and ESK (0.5% ropivacaine plus esketamine 0.2 mg/kg) for genicular nerve and IPACK blocks. The primary outcome was the incidence of CPSP (Numerical Rating Scale ≥ 4) at 6 months. Secondary outcomes included opioid consumption, NRS pain scores, Timed Up and Go (TUG) test, walking distance, Quality of Recovery-15 (QoR-15) scores, and adverse events. Results: At 6 months, the incidence of CPSP was significantly lower in the ESK group (4.9%) than in the ROP (17.9%) and CTRL (27.0%) groups. Esketamine significantly reduced overall pain burden (AUC = 559.3 ± 59.0 vs 641.9 ± 55.8 and 679.2 ± 58.5; Conclusion: Esketamine as an adjuvant to ropivacaine in genicular and IPACK blocks significantly reduced CPSP incidence and improved early functional recovery after TKA without increasing adverse effects. Perineural esketamine may represent a safe and effective strategy to prevent pain chronification.
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