艾斯氯胺酮对剖宫产产妇术后镇痛效果及呼吸循环功能的影响

Influence of esmketamine on postoperative analgesia efficacy and respiratory circulation function of parturients undergoing cesarean section

目的探究艾司氯胺酮对剖宫产产妇术后镇痛效果,并分析药物对呼吸循环的影响。方法选择2018年1月—2020年1月于本院接受治疗的60例剖宫产妇为研究对象,按照随机数表法分为研究组和对照组两组,每组各30例。研究组在硬膜外阻滞完善后静注少量艾司氯胺酮,对照组则在硬膜外阻滞完善后静注等量生理盐水。对比两组产妇产后2 h、4 h、12 h、24 h时的视觉模拟量表评分、简易智力评分以及血氧饱和度(SaO_(2)),对比产后3d新生儿神经行为评分,评估两组产妇不良反应诸如恶心、呕吐、头晕、瘙痒等的发生率。结果研究组产妇的视觉模拟量表评分均明显低于对照组,差异有统计学意义(P<0.05);两组产妇产后简易智力量表评分比较,差异无统计学意义(P>0.05);产后2 h以及产后4 h,研究组产妇的(SaO_(2))高于对照组,差异有统计学意义(P<0.05);产后12 h以及产后24 h,两组产妇(SaO_(2))比较,差异无统计学意义(P>0.05);产后3 d,两组新生儿神经行为量表中一般状态、原始反射、主动肌张力、被动肌张力以及行为能力比较,差异无统计学意义(P>0.05);两组产妇不良反应总发生率比较,差异无统计学意义(P>0.05)。结论艾司氯胺酮对剖宫产产妇具有较好的术后镇痛效果,同时还有助于改善产妇产后短期呼吸循环能力,且该药对新生儿影响较小,产妇产后不良反应也未明显升高,值得临床推广应用。

Objective To explore the analgesic effect of esmketamine on cesarean section puerpera,and analyze the influence on respiration and circulation.Methods 60 cases of cesarean section puerpera treated in our hospital from January 2018 to January 2020 were selected as the research objects,and they were divided into study group and control group according to random number table method,30 cases in each group.Patients in the study group were intravenously administrated with small amount of esmketamine after completion of epidural block,while patients in control group were given equal amount of normal saline.The visual analogue scale(VAS)score,mini-mental state examimation(MMSE)score and blood oxygen saturation(SaO_(2))at 2 h,4 h,12 h and 24 h after delivery were compared between the two groups,and the neonatal neurobehavioral(NBNA)score at 3d after delivery was compared.The incidence of adverse reactions such as nausea,vomiting,dizziness and pruritus in the two groups were evaluated.Results the VAS scores of the study group were lower than those of the control group at 2 h,4 h,12 h and 24 h after delivery(P<0.05),and there was no significant difference in MMSE scores between the two groups(P>0.05).The(SAO_(2))of the study group was higher than that of the control group at 2h and 4h after delivery(P<0.05),but there was no significant difference in(SAO_(2))of the two groups at 12h and 24 h after delivery.At postpartum 3 days,there was no significant difference in general state,primary reflex,active muscle tone,passive muscle tone and behavioral ability between the two groups(P>0.05).The incidence of adverse reactions in the study group was 16.67%,which was higher than 10.00%in the control group,but the difference was not significant(P>0.05).Conclusions Esmketamine has a good postoperative analgesic effect on cesarean section,and it also helps to improve the short-term postpartum respiratory and circulatory capacity,and it has little effect on newborns,and the postpartum adverse reactions are not significantly increased,so it is worthy of clinical application.