艾司氯胺酮复合地佐辛对剖宫产术后静脉自控镇痛产妇恢复质量、康复情况的影响

Effect of esmketamine combined with dezocine on recovery quality and rehabilitation of parturients with patient-controlled intravenous analgesia after cesarean section

目的探讨盐酸艾司氯胺酮注射液复合地佐辛注射液对剖宫产术后静脉自控镇痛(PCIA)产妇恢复质量、康复情况的影响。方法选取2021年12月—2022年4月桐城市人民医院收治的80例美国麻醉医师协会(ASA)Ⅰ~Ⅱ级单胎剖宫产产妇,根据随机数字表法将所有患者分为对照组和治疗组,每组各40例。对照组产妇给予枸橼酸舒芬太尼注射液(2μg/kg)+地佐辛注射液(0.2 mg/kg)+昂丹司琼(8 mg);治疗组给予盐酸艾司氯胺酮注射液(1 mg/kg)+地佐辛注射液(0.2 mg/kg)+昂丹司琼(8 mg)。比较两组术后40项恢复质量量表(QoR40)评分、术后静脉自控镇痛有效按压次数、首次下床活动时间、首次排气时间、首次排尿时间、不良反应的发生情况。结果与对照组比较,术后24、48 h治疗组舒适度评分、情绪状态评分、心理支持评分、总评分均显著升高,差异有统计学意义(P<0.05)。治疗组术后首次下床活动时间、首次排尿时间、首次排气时间均明显短于对照组,差异有统计学意义(P<0.05)。两组产妇头晕、恶心呕吐差异有统计学意义(P<0.05)。结论盐酸艾司氯胺酮注射液复合地佐辛注射液用于产妇剖宫产术后PCIA,可产生良好的情绪和舒适度,提高早期恢复质量,促进术后康复进程。

Objective To explore the effect of Esketamine Hydrochloride Injection combined with Dezocine Injection on the recovery quality and rehabilitation of parturients with patient-controlled intravenous analgesia(PCIA)after cesarean section.Methods Parturients(80 cases)with PCIA after cesarean section in the People’s Hospital of Tongcheng from December 2021 to Apil 2022 were divided into control and treatment groups according to the random number table method,and each group had 40 cases.Patients in the control group were given Sufentanil Citrate Injection(2μg/kg),Dezocine Injection(0.2 mg/kg),and ondansetron(8 mg).Patients in the treatment group were given Esketamine Hydrochloride Injection(1 mg/kg),Dezocine Injection(0.2 mg/kg),and ondansetron(8 mg).The QoR40 scores,effective pressing times of postoperative PCIA,first time out of bed activity time,first exhaust time,first urination time,and adverse reactions in two groups were compared.Results Compared with the control group,the comfort score,emotional state score,psychological support score,and total score of the treatment group were significantly increased at 24 h and 48 h after operation(P<0.05).The first time of getting out of bed,the first time of urination,and the first time of exhaust in the treatment group was significantly shorter than those in the control group(P<0.05).There was significant difference in dizziness,nausea,and vomiting between two groups(P<0.05).Conclusion Esketamine Hydrochloride Injection combined with Dezocine Injection for PCIA after cesarean section can produce good mood and comfort,improve the quality of early recovery,and promote the process of postoperative rehabilitation.