艾司氯胺酮联合硬膜外麻醉对剖宫产妇术后心理状态的影响  

Effect of esketamine combined with epidural anesthesia on psychological status of women after cesarean section

作　　者：王得程 WANG Decheng(Department of Anesthesiology,Wuwei People's Hospital,Weiwu 733099,China)

机构地区：[1]武威市人民医院麻醉科,威武733099

出　　处：《国际精神病学杂志》2024年第3期892-895,共4页Journal Of International Psychiatry

摘　　要：目的 探讨艾司氯胺酮复合硬膜外麻醉对剖宫产妇术后心理状况的影响。方法 将2021年5月~2022年5月我院产科行剖宫产分娩的100例产妇纳入研究。采取随机数字表法进行分组,两组各50例。两组产妇均在硬膜外麻醉下行剖宫产手术,观察组在此基础上加用艾司氯胺酮。比较两组产妇手术前后应激指标检测结果、爱丁堡产后抑郁评分表(EPDS)的变化情况以及术后不同时间疼痛程度、认知功能缺损情况的差异。结果 观察组术后1d血清皮质醇(Cor)、血浆肾上腺素(E)与去甲肾上腺素(NE)均低于对照组(P<0.05);观察组术后1d、术后1周EPDS评分均低于对照组(P<0.05);观察组术后2h、4h、12h、24h的视觉模拟评分法(VAS)评分均低于对照组(P<0.05);两组术后2h、4h、12h、24h的简易智力状态检查量表(MMSE)评分均未发生明显变化(P>0.05)。结论 艾司氯胺酮复合硬膜外麻醉能够减轻剖宫产妇的应激状态和术后疼痛感,改善产后心理状态。Objective To explore the effect of esketamine combined with epidural anesthesia on the psychological status of women after cesarean section.Methods 100 cases of puerpera in our hospital obstetric department cesarean delivery from 2021/05 to 2022/05 were randomly divided into observation group(50 cases)and control group(50 cases).Both groups of parturients were delivered by cesarean section under epidural anesthesia,and the observation group was given esketamine on this basis.The stress index before and after operation,Edinburgh Postpartum Depression Scale(EPDS),pain degree and cognitive impairment at different time after operation were compared.Results The levels of serum cortisol(Cor),plasma epinephrine(E)and norepinephrine(NE)in observation group were lower than those in the control group 1 day after surgery(P<0.05).The EPDS of observation group were lower than those of the control group 1 day and 1 week after surgery(P<0.05).The Visual analog scale(VAS)at 2h,4h,12h and 24h in the observation group were lower than those in the control group(P<0.05).There was no significant difference between the two groups in the score of Mini-Mental State Examination(MMSE)at 2h,4h,12h and 24h after operation(P>0.05).Conclusion Esketamine combined with epidural anesthesia can reduce the stress state and postoperative pain of cesarean section women.It can improve postpartum mental state.

关 键 词：剖宫产 艾司氯胺酮 硬膜外麻醉 应激状态 心理状态 

分 类 号：R749.99[医药卫生—神经病学与精神病学]