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| Effect of esketamine combined with butorphanol for postoperative analgesia of women after cesarean women and its influence on the postpartum status of the women |
| 1. Chuzhou Integrated Traditional Chinese and Western Medicine Hospital, Anhui University of Traditional Chinese Medicine, Chuzhou, Anhui Province, 239000; 2. The First Affiliated Hospital of Anhui Medical University |
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Abstract To evaluate the effect of esketamine combined with butorphanol for postoperative analgesia of women after cesarean women, and to study its influence on the postpartum status of the women. Methods: A total of 80 women who wanted cesarean section under combined spinal-epidural anesthesia were selected and were divided into two groups (40 cases in each group) according to the random number table from May 2020 to June 2021. The women in the control group were given butorphanol for patient-controlled intravenous analgesia after cesarean section, and the women in the study group were given esketamine combined with butorphanol for patient-controlled intravenous analgesia after cesarean section. The visual analogue scale (VAS) score and the Ramsay sedation score of the women at postoperative 2h, 6h, 12h, 24h, and 48h in rest or uterine contraction were compared between the two groups. The levels of serum 5-hydroxytryptamine (5-HT) and prolactin (PRL) of the women at levels before operation, and at postoperative 12h, 24h, and 48h were compared between the two groups. The score of Edinburgh Postpartum Depression Scale (EPDS) of the women in the postoperative 3rd day and the postoperative 6th weeks were compared between the two groups. The time of postpartum milk feeding, the start of lactation time, and the number of breastfeeding internal postoperative 48h of the women in the two groups were observed and recorded. The rate of adverse reactions of the women in the two groups was counted. Results: The VAS score of the women in the study group at postoperative 2h, 6h, 12h, 24h, or 48h in rest or uterine contraction was significantly lower than that of the women in the control group, and Ramsay scores of the women in the study group at postoperative 2h, 6h, 12h, or 24h was significantly better than that of the women in the control (P<0.05). The serum 5-HT level of the women in the two groups at postoperative 12h, 24h, or 48h had decreased significantly and the serum PRL level of the women in the two groups had significantly increased, and the improvements of which of the women in the study group were significantly better than those of the women in the control group (P<0.05). Compared with those of the women in the control group, the EPDS score of the women in the study group in the postoperative 3rd day or 6th week was significantly lower, the time of delivery to breastfeeding start of the women in the study group was significantly shorter, and the number of breastfeeding within postoperative 48 h of the women in the study group was significantly more (all P<0.05). There was no significant difference in the incidence of adverse reactions (20.0% vs.15.0%) between the two groups (P>0.05). Conclusion: The combination of esketamine and butorphanol can improve the analgesic effect after cesarean section of the women, which can alleviate their symptoms of depression, promote their improvement of lactation function with better safe.
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