parecoxib + esketamine + ropivacaine

Parecoxib + esketamine + ropivacaine is a multimodal analgesic combination being investigated for the management of postoperative pain and the prevention of postoperative delirium, particularly in elderly patients undergoing major surgeries such as hip replacement. This regimen, studied by Taian City Central Hospital, utilizes three distinct pharmacological pathways to optimize pain control while minimizing opioid consumption and cognitive side effects. Parecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor that reduces the synthesis of inflammatory prostaglandins. Esketamine, the S-enantiomer of ketamine, acts as a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, providing systemic analgesia and potential neuroprotective effects. Ropivacaine is an aminoamide local anesthetic that blocks voltage-gated sodium channels to inhibit nerve conduction, typically administered via regional techniques like the fascia iliaca compartment block.