Effect of Esketamine Combined with Ropivacaine Hydrochloride on Postoperative Mechanical Pain Threshold and Incidence of Postpartum Depression in Parturients Undergoing Labor
LIU Shuguang
ZHANG Chunyan
LIU Jingjing
HAN Jinsong
Abstract：Objective To investigate the efficacy of esketamine combined with ropivacaine hydrochloride in labor analgesia and its impact on postoperative mechanical pain threshold and incidence of postpartum depression.Methods A prospective study was conducted to select 90 parturients women who proposed to undergo labor analgesia at Zhoukou Central Hospital from September 2023 to June 2024.The patients were randomly assigned to a control group(45 cases)and an observation group(45 cases)using a random number table method.The parturients in control group were given ropivacaine hydrochloride+sufentanil,while parturients in the observation group were given esketamine in addition to the control group.The hemodynamic parameters,mechanical pain threshold,visual analog scale(VAS)score,labor duration(first stage of labor,second stage of labor,third stage of labor),delivery mode(natural delivery,cesarean section,instrumental delivery),depression status,incidence of perioperative adverse events were compared between the two groups at different time points.Results There were no statistically differences in mean arterial pressure(MAP)between the two groups of parturients at time points before analgesia(To),1 min after analgesia(T,),5 min after analgesia(T2),10 min after analgesia(T3),30 min after analgesia(T4),at full cervical dilation(T5),and during childbirth(T6)(P＞0.05).The heart rate(HR)of parturients in the observation group was lower than that in the control group at time points T2 and T3,with statistically significant differences(P＜0.05).The mechanical pain threshold and visual analog scale(VAS)scores of parturients in the observation group were lower than those in the control group at full cervical dilation and within 2 days postpartum(P＜0.05).There were no statistically significant differences in the duration of labor and mode of delivery between the two groups of parturients(P＞0.05).The Edinburgh postnatal depression scale(EPDS)scores of parturients in the observation group were lower than those in the control group within 1 month postpartum(P＜0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P＜0.05).Conclusion Mild circulatory effects of the combination of esketamine and ropivacaine hydrochloride in labor analgesia,can effectively increasing the maternal mechanical pain threshold,preventing hyperalgesia and postpartum depression,and has minimal adverse reactions that do not affect the labor process or delivery method.
Keywords：esketamineropivacaine hydrochloridemechanical pain thresholdpain sensitivitypostpartum depressionlabor analgesia
Publication Date：2025-09-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 3123-3128 )