Effects and influence of sleep quality small doses of esketamine combined with oxycodone postoperative analgesia in patients with laparoscopic hysterectomy
AIM To observe the analgesic effect and sleep quality of low dose of esketamine combined with oxycodone for patient-controlled intravenous analgesia(PCIA)in patients undergoing laparoscopic hysterectomy.METHODS A total of 78 patients undergoing laparoscopic hysterectomy from June 2022 to December 2023 were randomly divided into control group and esketamine group,with 39 patients in each group.Patients in the control group received a combination of 40 mg of oxycodone,100 pg of dexmedetomidine and 5 mg of tropisetron for postoperative analgesia.Patients in the esketamine group in addition to the treatment of the control group,received esketamine at a dose of 0.5 mg·kg-1 for postoperative analgesia.The visual analog scale(VAS)scores at rest and during movement were recorded at 0 h,6 h,12 h,24 h,48 h after surgery,and VAS scores were compared between 2 groups.The Pittsburgh sleep quality index(PSQI)and Hamilton depression scale(HAMD-17)scores in 2 groups were compared before surgery and 24 h,48 h after surgery.Levels of brain-derived growth factor(BDNF)and interleukin 6(IL-6)in 2 groups were detected and compared before operation,24 h and 48 h after operation.The consumption of oxycodone and number of effective pressing times of analgesic pump,number of rescue analgesia within 48 hours after the operation were compared between 2 groups.The occurrence of adverse reactions was compared.RESULTS Compared with the control group,the VAS scores at rest and during movement in the esketamine group were lower than in the control group at 0 h,6 h,12 h,24 h and 48 h after operation(P＜0.05).The PSQI and HAMD-17 scores were also lower than those in the control group at 24 h and 48 h after operation(P＜0.05).The level of brain-derived growth factor(BDNF)was higher and the level of IL-6 was lower than those in the control group at 24 h and 48 h after operation(P＜0.05).The consumption of oxycodone,the number of effective compressions and rescue time of analgesia,the incidence of nausea and vomiting in the esketamine group were lower than those in the control group at 48 h after surgery.No other adverse reactions occurred in 2 groups(P＞0.05).CONCLUSION Low dose of esmketamine combined with oxycodone could reduce VAS scores at rest and during movement,improve sleep quality,reduce depression,increase BDNF level,relieve IL-6 level,and reduce oxycodone consumption and the incidence of nausea and vomiting in patients undergoing laparoscopic hysterectomy,which is worthy of clinical promotion.
万方数据
维普
