Comparison of application effects of Ketorolac Tromethamine combined with Sufentanil and Dezocine combined with Sufentanil anesthesia in postpartum analgesia of patients undergoing cesarean section

WEI Ming; JIANG Yan; YE Renli; FENG Xiaofeng; SHI Xuebing

doi:10.3969/j.issn.1002-3429.2025.17.019

Abstract：Objective To explore the application value of Ketorolac Tromethamine(KT)or Dezocine combined with Sufentanil anesthesia during postpartum analgesia of patients undergoing cesarean section(C-section).Methods In total,102 patients undergoing C-section were selected from January to October 2022,and were divided into the observation group(KT combined with Sufentanil analgesia,n=52)and the control group(Dezocine combined with Sufentanil analgesia,n=50)by means of different postpartum analgesic drugs.The postoperative analgesic effect,stress response indicators[endothelin-1(ET-1),cortisol(Cor),norepinephrine(NE)]and neurotransmitters[neuropeptide Y(NPY),substance P(SP),β-endorphin(β-EP)]before surgery and at 24 and 48 h after surgery,first postoperative breastfeeding time,prolactin(PRL)before and after surgery and occurrence of postoperative adverse reactions were compared between the two groups.Results The visual analogue scale(VAS)pain score at 12,24 and 48 h after surgery was lower than that at 6 h after surgery(P<0.05),but there were no significant differences in the VAS pain scores between the two groups at 6,12,24 and 48 h after surgery(P>0.05).The pain threshold value at 1,4,8 and 24 h after surgery was enhanced compared with that before surgery(P<0.05),but there were no significant differences in pain threshold values before surgery and at 24 h after surgery between the two groups(P>0.05).At 24 and 48 h after surgery,the levels of ET-1,Cor,NE,β-EP,SP and NPY in both groups were higher than those before surgery,and the above levels in the observation group at 24 and 48 h after surgery were lower than those in the control group(P<0.05,P<0.01).The first postoperative breastfeeding time in the observation group was shorter compared with that in the control group(P<0.01).The PRL levels in both groups at 4,12,24 and 48 h after surgery were higher than those before surgery,and the levels of PRL in the observation group at 4,12,24 and 48 h after surgery were higher than those in the control group(P<0.05,P<0.01).The total incidence rate of adverse reactions in the observation group after surgery was lower than that in the control group(P<0.05).Conclusion KT or Dezocine combined with Sufentanil have similar analgesic effects during postpartum analgesia of patients undergoing C-section,but KT combined with Sufentanil can better improve the stress response,reduce the levels of neurotransmitters,improve the early postpartum lactation,and reduce the adverse reaction,and it can promote the postoperative recovery of patients more effectively.