Effect of subanesthetic dose of esketamine on postoperative hyperalgesia and postpartum depression in patients undergoing caesarean section
Objective To investigate the effect of subanesthetic dose of esketamine on remifentanil-in-duced hyperalgesia after cesarean section under general anesthesia,and its effect on serum homocysteine(Hcy)level and postpartum depression.Methods A total of fifty patients undergoing cesarean section under general anesthesia were randomly divided into the esketamine group and the control group(25 cases in each group).The two groups were given esketamine 0.2 mg/kg and the same amount of normal saline by slow in-jection 10 min after fetal delivery.Then,the extubation time,visual analogue scale(VAS)score within two hours after operation,and consumption of morphine while in the post-anaesthesia care unit(PACU)were compared between the two groups.The Edinburgh Postnatal Depression Scale(EPDS)scores were compared at one day before surgery,one day,four days,and one month after surgery.Serum Hcy levels were measured at one day before surgery,one day and four days after surgery.Results There was no significant difference in extubation time between the two groups(P>0.05).Compared with the control group,it took a longer time for patients in the esketamine group to have a VAS score≥4 for the first time,but the time from morphine injection to a VAS score<4 was shortened(P<0.05).The amount of morphine used in the esketamine group was lower than that in the control group in PACU(P<0.05).Compared with the control group,the VAS scores of the esketamine group decreased at 15 min,30 min,45 min,one hour,and 90 min after surgery(P<0.05),while there was no statistical significance difference in VAS scores at two hours after surgery(P<0.05).EPDS scores in the esketamine group were lower than those in the control group at one day and four days after surgery(P>0.05),but there was no statistically significant between the two groups at one month after surgery(P>0.05).Serum Hcy level in the esketamine group was lower than that in the control group at one day and four days after surgery(P<0.05).Conclusion The subanesthetic dose of esketamine during caesarean section under general anesthesia can effectively relieve remifentanil-induced postoperative hy-peralgesia and prevent the occurrence of postpartum depression.
万方数据
维普
