Effects of Different Doses of Esketamine on Postoperative Pain and Emotional State in Patients Undergoing Laparoscopic Total Hysterectomy
Objective:To investigate the effects of different doses of esketamine on postoperative pain and emotional state in pa-tients undergoing laparoscopic total hysterectomy.Methods:According to the random number table method,120 patients who were un-dergoing laparoscopic total hysterectomy in our Hospital from January 2022 to April 2023 were selected,and divided into a control group(group A,n=40),esketamine 0.25 mg/kg group(group B,n=40)and esketamine 0.5 mg/kg group(group C,n=40).Perioperative indica-tors,The pain rating scale(NRS)scores at 1,4,8,24 h and 48 h after operation,the self-rating anxiety scale(SAS)scores and self-rating depression scale(SDS)scores at 1 day before operation(PRE1),1 day after operation(POD1)and 2 days after operation(POD2),hemo-dynamic indicators and adverse reactions were compared in three groups.Results:The dosage of sufentanil analgesics 24 h after surgery and the number of rescue analgesia cases in Group B and Group C were smaller than those in Group A,while the awakening time and extubation time in Group A and Group B were shorter than those in Group C(P＜0.05).The NRS scores of Group B and Group C at 1 h after surgery were lower than those of Group A(P＜0.05).The NRS scores of Group B at 4 h,8 h and 24 h after surgery were lower than those of Group A,and the NRS scores at 4 h,8 h after surgery were lower than those of Group C(P＜0.05).Compared with the intra group PRE1,the SAS and SDS scores of POD1 in three groups increased(P＜0.05).The SAS and SDS scores of POD1 and POD2 in group B and group C were lower than those in group A,and group C was lower than group B(P＜0.05).Compared with the intra group PRE1,the SAS and SDS scores of POD2 in group A increased(P＜0.05).Compared with the intra group PRE1,the SDS of group B POD2 and the SAS and SDS of group C POD2 were both reduced(P＜0.05).At T3 moment,the mean arterial pressure(MAP)and heart rate(HR)of group B and group C were lower than those of group A(P＜0.05).The incidence of postoperative nausea and vomitting in group B and group C were lower than that in group A P＜0.05).The incidence of postoperative dizziness and delaye of recovery in group A and group B were lower than that in group C(P＜0.05).There was no statistically significant difference in resortification period restlessness and res-piratory depression in three groups(P＜0.05).Conclusion:The clinical effect of 0.25 mg/kg esketamine on reducing postoperative pain,reducing the dosage of opioids and improving negative emotions in patients undergoing laparoscopic total hysterectomy is better.
EsketamineDosesLaparoscopic total hysterectomyPainAnxietyDepression
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