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| Application effect of the different dosages of esketamine used in painless induced abortion based on Cite Space literature analysis |
| 1. Changzhi Medical College, Changzhi, Shanxi Province, 046000; 2. Changzhi Maternal and Child Health Care Hospital, Shanxi Province |
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Abstract To analyze the literature with the subject words of "painless abortion" and "esketamine" in domestic CNKI by Cite Space, to find the research hotspots on the painless abortion, and to explore the application effect of the different dosages of esketamine used in painless induced abortion. Methods: The literatures were searched by the subject words of"painless abortion" and "Esketamine" in the database of China National Knowledge Network (CNKI), and the retrieved literatures were imported into Cite Space software. The forefront and hot spots of the painless abortion research at home and abroad from January 2012 to January 2023 were analyzed by Meta-analysis. 160 women who wanted painless abortion in the outpatient department from March to June 2023were selected in a cohort study, which included the women with esketamine (0.1mg/kg) combined with propofol for painless abortion in group E1, the women with esketamine (0.2mg/kg) combined with propofol for painless abortion in group E2, the women with esketamine (0.3mg/kg) combined with propofol for painless abortion in group E3 and the women with fentanyl (1ug/kg) combined with propofol in group F. The values of heart rate (HR), blood pressure (BP) and oxyhemoglobin saturation (SPO2) of the women in the four groups before anesthetic induction (T1), during dilation of uterine orifice (T2) and after abortion (T3) were observed. The time of recovery, the dosage of propofol, the score of VAS at 15min after recovery, the anesthetic effect and the incidence of adverse reactions of the women in the four groups were recorded. Results: A total of 2210 Chinese articles were included for meta-analysis. The analysis of hotspots showed that the clinical research literature on esketamine used in the painless abortion had increased, and which was a research hotspot of the painless abortion. The clinical observation showed that the values of MAP and SPO2 of the women in group E1, group E2 and group E3 at T2 and T3 were significantly higher than those of the women in group F, and the HR value of the women in group E1, group E2 and group E3 at T2 was significantly higher than that of the women in group F (all P<0.05). There was no significant difference in the HR value of the women at T3 among the four groups (P>0.05). The VAS scores of the women in group E2 and in group E3 were significantly lower than those of the women in group E1 and in group F. The recovery time and the incidence of somnolence of the women in group E1, group E2 and group F were significantly better than those of the women in group E3. The rate of excellent and good of the anesthesia effect of the women in group E1, group E2 or group E3 (95.0%, 97.5% or 97.5%) was significantly better than that (80.0%) of the women in group F. The incidence of the respiratory depression of the women in group E1, group E2 or group E3 (5.0%, 7.5% or 5.0%) was significantly lower than that (27.5%) of the women in group F (all P<0.05). There were no significant differences in the incidences of dizziness, headache, nausea and vomiting, and injection pain of the women among the four groups (P>0.05). Conclusion: Meta-analysis of the literatures from CNKI database finds that esketamine used in painless abortion is a research hotspot. The clinical observation finds that 0.2mg/kg esketamine combined with propofol for painless abortion of the women has the best effectiveness and safety.
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