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艾司氯胺酮静脉镇痛泵对剖宫产术后疼痛及抑郁的影响。

Impact of esketamine intravenous analgesic pump on pain and depression post-cesarean.

作者信息

Zhang Xiao-Qiang, Li Shuang, Qin Xiao-Lin

机构信息

Department of Anesthesiology, Mengcheng County No. 1 People's Hospital, NO. 282 Shopping Mall Road East, Chengguan Community, Mengcheng County, Bozhou, 233500, Anhui Province, China.

出版信息

BMC Surg. 2025 Apr 8;25(1):144. doi: 10.1186/s12893-025-02868-y.

Abstract

BACKGROUND

Postoperative pain and psychological well-being in postpartum women following cesarean section are critical for optimal maternal recovery. Traditional analgesics often have limitations and side effects, prompting the need for alternative solutions. This study evaluates the impact of an esketamine intravenous analgesic pump on postoperative pain and psychological status in postpartum women following cesarean section.

METHODS

A comprehensive retrospective evaluation was conducted at our institution from October 2021 to July 2023, including 168 patients who underwent cesarean delivery. The observation group (n = 82) received esketamine via an intravenous analgesic pump, while the control group (n = 86) received traditional analgesic therapy. Data collected included demographic information, surgical details, postoperative pain (assessed using the Visual Analog Scale, VAS), psychological status (assessed using the Edinburgh Postnatal Depression Scale, EPDS), recovery metrics, and adverse reactions.

RESULTS

The observation group demonstrated consistently lower VAS scores at all postoperative time points compared to the control group, indicating superior pain control. EPDS scores were significantly lower in the observation group at 3, 5, and 14 days postoperatively, suggesting better psychological outcomes. The incidence of postpartum depression was also lower in the observation group at 3, 5, and 14 days. Recovery metrics such as time to first ambulation, first flatus, and initiation of lactation were significantly improved in the observation group. There were no significant differences in the incidence of adverse reactions between the groups.

CONCLUSIONS

The use of the Esketamine Intravenous Analgesic Pump significantly reduces postoperative pain and the incidence of postpartum depression within the first 14 days. It promotes early recovery and breastfeeding in postpartum women without significant adverse reactions, making it a valuable addition to postoperative care.

摘要

背景

剖宫产术后产妇的疼痛及心理健康状况对于产妇的最佳恢复至关重要。传统镇痛药往往存在局限性和副作用,因此需要其他替代方案。本研究评估了艾司氯胺酮静脉镇痛泵对剖宫产术后产妇疼痛及心理状态的影响。

方法

于2021年10月至2023年7月在我院进行了一项全面的回顾性评估,纳入168例行剖宫产的患者。观察组(n = 82)通过静脉镇痛泵接受艾司氯胺酮治疗,对照组(n = 86)接受传统镇痛治疗。收集的数据包括人口统计学信息、手术细节、术后疼痛(采用视觉模拟评分法,VAS评估)、心理状态(采用爱丁堡产后抑郁量表,EPDS评估)、恢复指标及不良反应。

结果

与对照组相比,观察组在所有术后时间点的VAS评分均持续较低,表明疼痛控制更佳。观察组在术后3天、5天和14天的EPDS评分显著更低,提示心理结局更好。观察组在术后3天、5天和14天的产后抑郁发生率也更低。观察组在首次下床活动时间、首次排气时间及开始泌乳等恢复指标方面有显著改善。两组间不良反应发生率无显著差异。

结论

使用艾司氯胺酮静脉镇痛泵可显著减轻术后疼痛,并降低产后14天内的产后抑郁发生率。它促进了产后妇女的早期恢复及母乳喂养,且无明显不良反应,是术后护理中的一项有价值的补充措施。

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