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| Effects of esketamine used during gynecological laparoscopic surgery of patients on their postoperative hyperalgesia |
| The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui Province, 230031 |
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Abstract To explore the effects of esketamine used during gynecological laparoscopic surgery of patients on their surgical indicators, pain situation, pain threshold, pain sensitive area, sufentanil dosage and safety. Methods: A total of 94 patients with lesions in uterus or ovarian who wanted laparoscopic lesions ectomy under general anesthesia were selected and were divided into two groups (47 patients in each group) according to random number table method from September 2022 to December 2023. The patients in the study group were injected with esketamine before anesthesia induction, and the patients in the control group were injected with the same amount of normal saline before anesthesia induction. The surgical indexes, the conditions of static and dynamic pain before and after operation, the pain sensitivity threshold and the area of the mechanical pain sensitivity of the incision, and the adverse reactions rate of the patients were compared between the two groups. Results: The eye opening time (12.11±1.38 min) and the tracheal tube removal time (14.89±2.46 min) of the patients in the study group were significantly lower than those (13.24±1.69 min and 16.03±2.51 min) of the patients in the control group. The static and dynamic visual analogue scores (1.57±0.87 points and 2.06±1.04 points) of the patients in the study group were significantly lower than those (2.23±1.09 points and 2.74±1.18 points) of the patients in the control group. The mechanical hyperalgesia thresholds of the incision and the medial arm (52.03±8.29g and 54.87±8.34g) of the patients in the study group were significantly higher than those (40.56±7.62g and 43.55±7.68g) of the patients in the control group. The mechanical hyperalgesia area of the incision and medial arm (52.36±6.55 cm2 and 50.21±6.94 cm2) in the study group were significantly lower than those (64.18±7.69 cm2 and 63.42±7.58 cm2) of the patients in the control group. The dosage of sufentanil used in postanesthesia care unit (PACU) (17.16±2.31μg), at 6h after discharge (19.24±3.10μg) and at 18h after discharge (16.13±2.57μg) of the patients in the study group were significantly lower than those (19.54±3.14μg, 22.79±3.58μg and 16.13±2.57μg) of the patients in the control group. The incidence of the adverse reactions (12.8%) of the patients in the study group was significantly lower than that (34.0%) of the patients in the control group (all P<0.05). Conclusion: Esketamine used during gynecological laparoscopic surgery of the patients can effectively inhibit their postoperative hyperalgesia, improve their operation recovery indexes, and decrease their adverse reaction, and with better safety.
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