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| Effects of the small dose of ketamine combined with dexmedetomidine used during cesarean section on postoperative pain and postpartum recovery |
| Huangshan Shoukang Hospital, Huangshan, Anhui Province, 245000 |
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Abstract To observe the effects of the small dose of ketamine combined with dexmedetomidine used during cesarean section of women on their postoperative pain and postpartum recovery. Methods: A total of 80 women who wanted cesarean section under combined spinal-epidural anesthesia(CSEA) were selected and were divided into two study group and control group(40 cases in each group) by random number table method from October 2020 to October 2022. The women in the two groups were all given 0.5 μg/kg dexmedetomidine pumped before anesthesia. The women in the study group were given 0.25 mg/kg ketamine intravenous injections after fetal disengagement additionally. The postoperative score by visual analog scale(VAS), the levels of stress response index, such as epinephrine(E), norepinephrine(NE), and cortisol(Cor), the postoperative score by 40-item quality of recovery rating scale(QoR-40), and the preoperative and postoperative scores by Edinburgh Postpartum Depression Scale(EPDS) of the women were compared between the two groups. The adverse reactions of the women in the two groups were statistics analyzed. Results: The VAS scores of the women in the study group at postoperative 2 h, 6 h, 12 h and 24 h were significantly lower than those of the women in the control group. The E, NE and Cor levels of the women in the two groups at postoperative 6 h and 24 h were significantly higher than those of the women before operation, but which of the women in the study group were significantly lower than those of the women in the control group. The QoR-40 scores of the women in the study group at postoperative 24 h and 48 h(189.74±2.82 points and 194.15±3.14 points) were significantly higher than those(176.13±3.27 points and 183.06±3.59 points) of the women in the control group. The EPDS score of the women in the two groups at postoperative 24 h and in postoperative 5 days were significantly higher than those of the women before operation, but which(6.18±2.24 points and 5.47±2.06 points) of the women in the study group were significantly lower than those(7.64±2.65 points and 6.50±2.31 points) of the women in the control group(all P<0.05). There was no significant difference in the incidence of the adverse reactions of the women between the two groups(P>0.05). Conclusion: The application of the small dose of ketamine combined with dexmedetomidine in cesarean section of the women can reduce their postoperative pain, reduce their stress response and depression, and improve their quality of postpartum recovery, and with the safety and reliability.
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