ReviewCureus2026
Efficacy and Safety of Esketamine in Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTotal hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly performed procedures, but post-operative recovery is often complicated by significant pain, opioid-related side effects, and psychological distress. Esketamine has been proposed as an adjunct due to its analgesic and antidepressant properties, but its efficacy and safety remain unclear. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed by searching PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) up to July 2025. Dichotomous and continuous outcomes were synthesized using risk ratios (RRs) and standardized or mean differences, each reported with 95% confidence intervals (CIs). Results: Seven RCTs involving 1,101 patients were included. Esketamine did not significantly reduce pain at rest at 12 or 24 hours. Low-certainty evidence suggested that esketamine may reduce pain during activity at 12 hours (standardized mean difference (SMD): -0.28; 95% CI: -0.45, -0.12; p < 0.001), although this effect was not sustained at 24 hours. Very low-certainty evidence suggested a possible reduction in anxiety scores at post-operative day 7, with no significant effect observed at day 1. No clear effect on depression was observed at any time point. Esketamine was associated with a higher incidence of hallucinations (RR: 4.36; 95% CI (1.48, 12.88); p = 0.01), with no significant differences in delirium, nightmares, or post-operative nausea and vomiting.
conclusionsLow- to very low-certainty evidence suggests that esketamine may provide modest short-term improvement in activity-related pain and delayed anxiety reduction following THA and TKA. However, findings should be interpreted cautiously given the limited number of studies, clinical heterogeneity, and instability observed in sensitivity analyses. Esketamine was also associated with an increased risk of hallucinations.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.