艾司氯胺酮联合硬膜外阻滞在剖宫产产妇中的应用效果  

Application effects of Esketamine combined with epidural block in cesarean section parturients

作　　者：梁国友 LIANG Guoyou(Operating Room of Fuzhou Linchuan District Hospital of Traditional Chinese Medicine,Fuzhou 344100 Jiangxi,China)

机构地区：[1]抚州市临川区中医院手术室,江西抚州344100

出　　处：《中国民康医学》2025年第3期61-63,67,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察艾司氯胺酮联合硬膜外阻滞在剖宫产产妇中的应用效果。方法:选取2022年3月至2024年3月在该院进行剖宫产的60名产妇进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各30名。对照组采用硬膜外阻滞麻醉,观察组在对照组基础上联合艾司氯胺酮麻醉,比较两组术后疼痛程度[视觉模拟评分法(VAS)]评分,手术前后应激指标[去甲肾上腺素(NE)、皮质醇(Cor)]水平、产后抑郁[爱丁堡产后抑郁量表(EPDS)]评分,以及术后3 d不良反应发生率。结果:观察组术后2、6、12 h的VAS评分均低于对照组,差异有统计学意义(P<0.05);术后24 h,两组NE、Cor水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后3 d,两组EPDS评分均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:艾司氯胺酮联合硬膜外阻滞应用于剖宫产产妇可降低疼痛程度评分、应激指标水平和产后抑郁评分,效果优于单纯硬膜外阻滞。Objective:To observe application effects of Esketamine combined with epidural block in cesarean section parturients.Methods:A prospective study was conducted on 60 parturients who underwent cesarean section in this hospital from March 2022 to March 2024.According to the random number table method,they were divided into control group and observation group,30 cases in each group.The control group was treated with epidural block anesthesia,while the observation group was combined with Esketamine anesthesia on the basis of that of the control group.The postoperative pain degree[visual analogue scale(VAS)]score,the stress response index[norepinephrine(NE),cortisol(Cor)]levels and the postpartum depression[Edinburgh postnatal depression scale(EPDS)]score before and after the surgery,and incidence of adverse reactions 3 days after the surgery were compared between the two groups.Results:The VAS scores of the observation group 2,6 and 12h after the surgery were lower than those of the control group,and the differences were statistically significant(P<0.05).24 h after the surgery,the levels of NE and Cor in the two groups were higher than those before operation,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).3 days after the surgery,the EPDS scores of the two groups were higher than those before operation,but that in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Esketamine combined with epidural block in the cesarean section parturients can reduce the pain scores,the stress response index levels and the postpartum depression scores.Moreover,it is superior to simple epidural block anesthesia.

关 键 词：剖宫产 硬膜外阻滞 艾司氯胺酮 疼痛 应激反应 产后抑郁 不良反应 

分 类 号：R614[医药卫生—麻醉学]