艾司氯胺酮用于产妇椎管内麻醉下行剖宫产术后自控静脉镇痛的镇痛效应研究

Analysis of the Analgesic Effect of Esketamine for Postoperative PCIA of Cesarean Section Under Intravertebral Anesthesia in Parturient Women

目的 探讨对椎管内麻醉下剖宫产手术产妇采用艾司氯胺酮药物完成术后自控静脉镇痛(patient controlled intravenous analgesia, PCIA)的应用效果。方法 回顾性选取2022年3月—2023年9月临沂市中心医院的100例椎管内麻醉下剖宫产手术产妇的临床资料。按麻醉药物的不同进行分组,每组50例。参照组PCIA镇痛期间应用舒芬太尼,研究组在参照组基础上应用艾司氯胺酮。比较两组术后24 h镇痛泵平均按压次数、术后疼痛程度、不良反应发生率。结果 研究组术后24 h镇痛泵平均按压次数为(5.42±1.01)次,低于参照组的(8.22±1.05)次,差异有统计学意义(t=13.589,P<0.05)。研究组术后疼痛程度评分低于参照组,差异有统计学意义(P均<0.05)。研究组不良反应总发生率低于参照组,差异有统计学意义(P<0.05)。结论 椎管内麻醉下剖宫产手术产妇在实施术后PCIA镇痛期间,应用艾司氯胺酮药物效果良好,有效改善疼痛程度。

Objective To investigate the effect of using esketamine drug to complete postoperative self-controlled in-travenous analgesia(PCIA)for parturient women under intrathecal anesthesia for cesarean delivery.Methods The clinical data of 100 cases of parturient women undergoing cesarean section under intrathecal anesthesia in Linyi Cen-tral Hospital from March 2022 to September 2023 were retrospectively selected.They were grouped according to the different anesthetic drugs,with 50 cases in each group.The reference group applied sufentanil during PCIA analgesia,and the study group applied esketamine on the basis of the reference group.The average number of postoperative 24 h analgesic pump presses,postoperative pain level,and the incidence of adverse reactions were compared between the two groups.Results The average number of postoperative 24 h analgesic pump presses in the study group was(5.42±1.01)times,which was lower than(8.22±1.05)times of the reference group,and the difference was statistically signifi-cant(t=13.589,P<0.05).The postoperative pain level scores of the study group were lower than those of the reference group,and the differences were statistically significant(all P<0.05).The total incidence of adverse reactions in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Con-clusion During the implementation of postoperative PCIA analgesia for women undergoing cesarean section under in-trathecal anesthesia,the application of the drug esketamine was effective and efficient in improving the level of pain.