Optimal dose and safety of esketamine applied in epidural anesthesia for cesarean section
Objective To investigate the optimal dose and safety of esketamine in epidual analgesia for cesarean section.Methods A total of 150 puerperants who underwent cesarean section in Women and Children's Hospital Affiliated to Jiaxing University from May 2022 to December 2023 were enrolled.The puerperants were randomly assigned in three groups(E0.2,E0.3 and E0.4)with 50 cases in each group,to receive 0.2,0.3 and 0.4 mg/kg of esketamine for intravenous analgesia following epidural anesthesia,respectively.Systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were observed before administration,3 min after administration,at the time of delivery and at the end of operation,satisfaction with analgesia was assessed,and the incidence of drug-related complications(hypertension,tachycardia,bradycardia,nightmares,respiratory depression,nausea and vomiting,etc.)were recorded.The 1st and 5th-min Apgar scores of the neonates were also recorded.Results The difference in analgesia satisfaction among three groups of parturients is ststistically siguificant The analgesia satisfactory in group E0.3 and group E0.4 was higher than that in group E0.2(both P＜0.05),while there were no significant differences in umbilical artery pH and neonatal Apgar score among the three groups(both P＞0.05).There were no significant differences in SPB,DBP,and HR before and after administration in groups E0.2 and E0.3;while there were significance differences in group E0.4(all P＜0.05).There was no statistically significant difference in the incidence of complications among the three groups of postpartum women.Conclusion Eesketamine 0.3 mg/kg may be the optimal dose for puerperants undergoing cesarean section following epidural analgesia,which can increase the analgesic satisfaction,maintain stable hemodynamics without increasing the incidence of maternal and infant complications.
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