首页|艾司氯胺酮对剖宫产生育二孩或三孩妊娠期肥胖孕妇产后恢复抑郁状况和睡眠质量的影响

艾司氯胺酮对剖宫产生育二孩或三孩妊娠期肥胖孕妇产后恢复抑郁状况和睡眠质量的影响

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目的 探讨艾司氯胺酮对剖宫产生育二孩或三孩妊娠期肥胖孕妇产后恢复、抑郁状况和睡眠质量的影响。方法 选取2022年2月至2023年12月于湖州市南浔区人民医院剖宫产生育二孩或三孩的妊娠期肥胖孕妇86例为研究对象,按麻醉方法分为对照组和观察组,每组43例,在剖宫产术后,2组分别使用舒芬太尼、艾司氯胺酮联合舒芬太尼进行镇痛。对2组的疼痛评分、产后恢复情况、抑郁状况和睡眠质量进行比较。结果 在术后6 h、12 h、24 h和48 h,观察组的视觉模拟评分(VAS)均低于对照组(P<0。05);观察组的肛门首次排气、膀胱恢复排尿和分泌初乳时间均短于对照组(P<0。05);在术后3 d、7 d、14 d和28 d,观察组的爱丁堡产后抑郁量表(EPDS)抑郁评分均低于对照组(P<0。05);在术后1 d、2 d和3 d,观察组的睡眠障碍发生率均低于对照组(P<0。05);观察组的术后镇痛不良反应总发生率低于对照组(P<0。05)。结论 对于剖宫产生育二孩或三孩的妊娠期肥胖孕妇,艾司氯胺酮术后镇痛可以降低其疼痛和抑郁程度,促进产后恢复,降低睡眠障碍发生率,不良反应少。
Effects of esketamine on postpartum recovery,depression and sleep quality in obese pregnant women with cesarean delivery of second or third child
Objective To investigate the effects of esketamine on postpartum recovery,depression and sleep quality in obese pregnant women with cesarean delivery of second or third child.Methods A total of 86 obese pregnant women who had cesarean delivery of second or third child in Pepople's Hospital of Nanxun Dis-trict from February 2022 to December 2023 were selected as the study objects and divided into a control group and an observation group according to treatment methods,with 43 cases in each group.After cesarean delivery,the two groups were treated with sufentanil and esketamine combined with sufentanil for analgesia,respectively.Pain scores,postpartum recovery,depression and sleep quality were compared between the two groups.Results The VAS pain scores in the observation group were significantly lower than those in the control group at 6 h,12 h,24 h and 48 h after surgery(P<0.05).The first anal exhaust,bladder recovery urination,and colostrum secretion time in observation group were significantly shorter than those in control group(P<0.05).The EPDS depression scores in the observation group were significantly lower than those in the control group at 3 d,7 d,14 d and 28 d after surgery(P<0.05).The incidence of sleep disorders in the observation group was significantly lower than that in the control group at 1 d,2 d,and 3 d after surgery(P<0.05).The total incidence of adverse reactions to postop-erative analgesia in the observation group was significantly lower than that in the control group(P<0.05).Conclu-sion For obese pregnant women who have cesarean delivery of second or third child,postoperative analgesia with esketamine can significantly reduce their pain and depression,promote postpartum recovery,reduce the incidence of sleep disorders,and have few adverse reactions,which deserves attention.

Cesarean sectionObesity,maternalDepression,postpartumSleep qualityEsketamine

刘尧网、钱彦、费美蓉、刘猛、芦勤凤

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浙江省湖州市南浔区人民医院麻醉科,浙江湖州 313009

浙江省湖州市南浔区人民医院妇产科,浙江湖州 313009

剖宫产术 妊娠期肥胖 抑郁症,产后 睡眠质量 艾司氯胺酮

2024

中国药物与临床
中国医院协会

中国药物与临床

影响因子:0.846
ISSN:1671-2560
年,卷(期):2024.24(14)