The effect of different doses of esketamine combined with sufentanil for patient-controlled intravenous an-algesia on postoperative sleep quality in patients undergoing abdominal hysterectomy
Objective To observe the effect of different doses of esketamine combined with sufentanil on sleep quality after abdominal hysterectomy with intravenous controlled analgesia.Mesthods A retrospective study was conducted to select 62 patients who underwent abdominal hysterectomy with esketamine in the analgesia in Jiangsu Province Hospital of Traditional Chinese Medicine from September 2022 to September 2023,and 31 patients without esketamine in the controlled intravenous analgesia.The patients were divided into group C,low dose group and high dose group according to the availability and dosage of esketamine.Group C:sufentanil 2.5µg/kg+tropisetron 6 mg;lose dose group(ES1):Esketamine 0.5 mg/kg+sufentanil 2.5µg/kg+tropisetron 6 mg;high dose group(ES2):Esketamine 1 mg/kg+sufentanil 2.5µg/kg+tropisetron 6mg.Relevant patient data of three groups was analysed,including the Pittsburgh sleep quality index(PSQI)at the preoperative day,postoperative day,the second day after surgery,the serum cortisol con-centration at 6 am the day before surgery and the third day after surgery;ratio of patients with mild resting pain at 6,12,24,48 hours after surgery,the number of PCIA compressions 48 hours after surgery and the occurrence of adverse reactions.Results PSQI of the ES2 at postoperative day,the second day after surgery were lower than that of the group C(P<0.05),PSQI of the ES1 group at postoper-ative day,the second day after surgery were lower than that of the group C(P<0.05),PSQI of the ES2 group at postoperative day were lower than that of the ES1 group(P<0.05).Serum cortisol concentration of the ES2 group were lower than that of the group C and the ES1 group(P<0.05)at the third day of the surgery,Serum cortisol concentration of the ES1 group were lower than that of the group C(P<0.05)at the third day of the surgery.The ES2 group had the highest number of postoperative mild pain at 6 hours after surgery.There was no sta-tistical difference at other time points.The postoperative patient-controlled frequency decreased significantly in ES2 group.There was no statistical difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion 1mg/kg esketamine combined with sufentanil 2.5 µg/kg for patient-controlled intravenous analgesia after abdominal hysterectomy can improve the sleep quality,and have the better postoperative analgesic effect.
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