Effect of Esketamine on PCIA after Cesarean Section in Elderly Parturient Women and Its Impact on Pain and Depression

DENG Hongmei; SONG Xue; FAN Yong

doi:10.3969/j.issn.1002-3429.2024.09.016

Abstract：Objective To explore the effect of Esketamine on patient controlled intravenous analgesia(PCIA)after cesarean section in elderly parturient women and its impact on severity of pain and depression.Methods A total of 160 eld-erly parturient women who underwent cesarean section from September 2021 to December 2023 were selected and divided into observation group(n=80)and control group(n=80)according to random number table method.The control group received PCIA analgesia medication including Sufentanil+Ondanseetron+Butorphanol,and the observation group was supplemented with Esketamine on the basis of the control group.The postoperative recovery,rescue analgesic rate and numerical rating scale(NRS)score at 2,6,12,24 and 48 h after operation were compared between the two groups.The changes of mean arterial pressure(MAP)and heart rate(HR)were recorded at the beginning of pumping,20 min after pumping and the end of pum-ping.Edinburgh Postpartum Depression Scale(EPDS)score was assessed at 3,5 and 7 d after operation.The incidence of adverse reactions within 48 h after operation was recorded.Results Compared with the control group,the first time of off-bed activity,time to colostrum,time of first anal exhaust and duration of hospital stay in the observation group were shorter,and the rescue analgesic rate was lower(P＜0.05,P＜0.01).The NRS score of the two groups increased first and then de-creased,and the NRS score of the observation group was lower than that of the control group at 2,6,12 and 24 h after opera-tion(P＜0.05).MAP and HR levels were increased in both groups,but the difference between the two groups was not statis-tically significant(P＞0.05).EPDS scores in the observation group were lower than those in the control group at 3,5 and 7 d after operation(P＜0.05).There was no difference in the incidence of adverse reactions between the observation group and the control group[11.25%(9/80)vs.8.75%(7/80)](P＞0.05).Conclusion Esketamine has a good analgesic effect in PCIA after cesarean section in elderly parturient women,which can promote rapid recovery after delivery,improve de-pression,and has a good safety.