布托啡诺复合小剂量艾司氯胺酮在剖宫产术后镇痛中的应用效果

Effect of Butorphanol Combined with Low Dose Esketamine on Analgesia after Cesarean Section

目的 研究布托啡诺复合小剂量艾司氯胺酮用于剖宫产术后镇痛的效果。方法 研究对象方便选取2020年3月—2021年10月于宿迁市第一人民医院行剖宫产的146例产妇,按随机数表法分为两组,各73例。对照组给予布托啡诺行术后镇痛,观察组给予布托啡诺复合小剂量艾司氯胺酮行术后镇痛,对比两组不良反应、镇痛效果、睡眠质量、产后抑郁及性功能评分。结果 与对照组比较,观察组产后4、24、48 hVAS评分均更低,差异有统计学意义(t=5.530、6.544、6.593,P<0.05)。与对照组比较,观察组产后2、6、12、24、48 h Ramsay评分均更低,差异有统计学意义(t=5.216、4.709、2.990、7.013、7.883,P<0.05)。与对照组比较,观察组产后EPDS评分更低,差异有统计学意义(t=9.409,P<0.05)。与对照组比较,观察组产后2个月、4个月FSFI评分均更高,差异有统计学意义(t=7.573、6.737,P<0.05)。观察组不良反应发生率(4.11%)低于对照组(20.55%),差异有统计学意义(χ^(2)=9.125,P<0.05)。结论 布托啡诺复合小剂量艾司氯胺酮用于剖宫产术后镇痛,可取得良好镇痛效果,可改善产妇睡眠质量,减少产后抑郁发生,改善产妇产后性功能,且不良反应少,可确保镇痛安全性。

Objective To study the analgesic effect of butorphanol combined with low dose esketamine after cesarean section.Methods The subjects of this study were 146 women who underwent cesarean section in the First People's Hospital of Suqian City from March 2020 to October 2021 were convenient selected.They were divided into two groups according to random number table method,with 73 cases in each group.The control group was given butorphanol for postoperative analgesia,and the observation group was given butorphanol combined with low-dose esketamine for postoperative analgesia.Adverse reactions,analgesia effect,sleep quality,postpartum depression and sexual function scores were compared between the two groups.Results Compared with the control group,the VAS scores at 4 h,24 h and 48 h after delivery in the observation group were lower,and the difference was statistically significant(t=5.530,6.544,6.593,P<0.05).Compared with the control group,Ramsay score at 2 h,6 h,12 h,24 h and 48 h postpartum in the observation group was lower,the difference was statistically significant(t=5.216,4.709,2.990,7.013,7.883,P<0.05).Compared with the control group,postpartum EPDS score in the observation group was lower,and the difference was statistically significant(t=9.409,P<0.05).Compared with the control group,FSFI scores in the observation group were higher at 2 and 4 months postpartum,and the difference was statistically significant(t=7.573,6.737,P<0.05).The incidence of adverse reactions in observation group(4.11%)was lower than that in control group(20.55%),and the difference was statistically significant(χ^(2)=9.125,P<0.05).Conclusion Butorphanol combined with small dose esketamine for postoperative analgesia after cesarean section,can achieve good analgesia effect,can improve maternal sleep quality,reduce the occurrence of postpartum depression,improve maternal postpartum sexual function,and less adverse reactions,can ensure the safety of analgesia.