小剂量艾司氯胺酮在二次剖宫产产妇产后抑郁及术后镇痛疗效的临床研究  

Clinical Study on the Effect of Low-dose Esketamine on Postoperative Analgesia and Postpartum Depression in Women with Second Cesarean Section

作　　者：凌斌 朱芸[2] LING Bin;ZHU Yun(Department of Anaesthesia,Nanjing Jiangning Hospital,Nanjing 211100,China;Department of Anaesthesia,Nanjing Jiangning Hospital of Traditional Chinese Medicine,Nanjing 211100,China)

机构地区：[1]南京市江宁医院麻醉科,江苏南京211100 [2]南京市江宁中医院麻醉科,江苏南京211100

出　　处：《湖北民族大学学报(医学版)》2025年第1期47-50,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察小剂量艾司氯胺酮对二次剖宫产产妇术后产后抑郁、镇痛效果的临床效果。方法选取2022年7月-2024年7月南京市江宁医院麻醉科收治的二次剖宫产产妇108例,按随机数字表分为对照组和研究组,每组各54例。两组均采用腰硬联合麻醉,手术结束后行自控硬膜外泵镇痛,对照组采用布托啡诺0.15 mg/kg+托烷司琼4 mg+生理盐水稀释成100 mL。研究组采用艾司氯胺酮0.2 mg/kg+帕洛诺司琼0.25 mg+生理盐水稀释成100 mL。比较两组术后恢复指标、产后抑郁程度、疼痛程度及术后生活质量的差异。结果研究组术后首次下床活动时间、首次排气时间、首次排尿时间均低于对照组(P<0.05)。研究组术后1、3、7、14 d产后抑郁评分均低于对照组(P<0.05)。研究组术后4 h静息VAS评分低于对照组,术后12、24 h静息、运动、宫缩VAS评分均低于对照组(P<0.05)。研究组术后24、48 h的QoR-40评分均高于对照组(P<0.05)。研究组不良反应发生率低于对照组(χ^(2)=4.788,P<0.05)。结论小剂量艾司氯胺酮应用于二次剖宫产产妇的术后,能够有效降低产后抑郁程度及术后疼痛,改善术后恢复质量,具有重要的临床应用价值。Objective To investigate the clinical study on the effect of low-dose Esketamine on postoperative analgesia and postpartum depression in women with second cesarean section.Methods 108 cases of second cesarean section maternal patients admitted to our hospital from July 2022 to July 2024 were selected and divided into the control group and the study group according to the random number table,with 54 cases in each group.Differences in postoperative recovery indexes,degree of postpartum depression,degree of pain and postoperative quality of life were compared between the two groups.Results The postoperative recovery indicators of the patients in the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).The postoperative 1 d,3 d,7 d and 14 d postpartum depression scores of patients in the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).The 4h postoperative resting VAS score of the study group was lower than that of the control group,and the 12 and 24 h postoperative resting,exercise,and contraction VAS scores were lower than that of the control group,and the difference was statistically significant(P<0.05).Compared with the control group,the QoR-40 scores of patients in the study group were significantly higher at 24 h and 48 h postoperatively,and the difference was statistically significant(P<0.05).Compared with the control group,adverse reactions were significantly lower in the study group,and the difference was statistically significant(P<0.05).Conclusion The postoperative application of small-dose Esketamine in women undergoing secondary cesarean section can effectively reduce the degree of postpartum depression and postoperative pain,and improve the quality of postoperative recovery,which has important clinical application value.

关 键 词：艾司氯胺酮 剖宫产妇 镇痛效果 产后抑郁 临床研究 

分 类 号：R614[医药卫生—麻醉学]