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| 不同剂量艾司氯胺酮复合舒芬太尼用于静脉自控镇痛的效果 |
| The effect of different doses of ketamine combined with sufentanil for intravenous patient-controlled analgesia |
| 投稿时间：2025-07-23 修订日期：2026-04-03 |
| DOI： |
| 中文关键词: 艾司氯胺酮 舒芬太尼 自控镇痛 剖宫产 |
| 英文关键词:Ketamine Sufentanil Self controlled analgesia Cesarean section |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨不同剂量艾司氯胺酮复合舒芬太尼用于静脉自控镇痛(PCIA)时对剖宫产产妇术后疼痛、产后抑郁的影响。方法 选取2023年1月至2024年1月在我院行剖宫产的产妇200例,采用信封法将产妇分为四组,即对照组、0.2mg/kg组、0.5mg/kg组和0.8mg/kg组,每组50例,其中对照组给予舒芬太尼PCIA,0.2mg/kg组、0.5mg/kg组和0.8mg/kg组在对照组基础上,分别给予0.2mg/kg、0.5mg/kg和0.8mg/kg艾司氯胺酮PCIA,观察各组术后视觉模拟评分法(VAS)评分、去甲肾上腺素(NE)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)、爱丁堡产后抑郁量表(EPDS)评分、首次下床活动时间、首次肛门排气时间、泌乳开始时间和不良反应。结果 0.5mg/kg组和0.8mg/kg组术后2h、4h、12h、24h时VAS评分低于0.2mg/kg组和对照组(P＜0.05)。0.5mg/kg组和0.8mg/kg组术后24h时NE、Cor和ACTH低于0.2mg/kg组和对照组(P＜0.05)。0.5mg/kg组和0.8mg/kg组术后24h、72h时EPDS评分低于0.2mg/kg组和对照组(P＜0.05)。0.5mg/kg组和0.8mg/kg组首次下床活动时间、首次肛门排气时间、泌乳开始时间短于0.2mg/kg组和对照组(P＜0.05)。0.5mg/kg组和0.8mg/kg组术后2h、4h、12h、24h时VAS评分,术后24h时NE、Cor和ACTH,术后24h、72h时EPDS评分,首次下床活动时间、首次肛门排气时间、泌乳开始时间,不良反应发生率比较差异均无统计学意义(P＞0.05)。结论 不同剂量艾司氯胺酮复合舒芬太尼用于剖宫产产妇自控镇痛时均有较好的效果,具有缓解术后疼痛,改善产后抑郁等优点,其中0.5mg/kg和0.8mg/kg剂量的艾司氯胺酮效果更好。 |
| 英文摘要: |
| Objective: To explore the effects of different doses of esketamine complex sufentanil for intravenous controlled analgesia (PCIA) on postoperative pain and postpartum depression in cesarean section. Methods: 200 pregnant women who underwent cesarean section in our hospital from January 2023 to January 2024 were selected and divided into four groups using the envelope method, namely the control group, 0.2mg/kg group, 0.5mg/kg group, and 0.8mg/kg group, with 50 cases in each group. The control group was given sufentanil, while the 0.2mg/kg group, 0.5mg/kg group, and 0.8mg/kg group were given 0.2mg/kg, 0.5mg/kg, and 0.8mg/kg ketamine, respectively. The postoperative visual analog scale (VAS) scores, norepinephrine (NE), cortisol (Cor), adrenocorticotropic hormone (ACTH), Edinburgh Postnatal Depression Scale (EPDS) scores, first mobilization time, first anal exhaust time, Start time of lactation and adverse reactions. Results: The VAS scores at 2, 4, 12, and 24 hours after surgery of the 0.5mg/kg group and 0.8mg/kg group were lower than those of the 0.2mg/kg group and the control group (P<0.05). At 24 hours after surgery, the NE, Cor, and ACTH levels in the 0.5mg/kg and 0.8mg/kg groups were lower than those in the 0.2mg/kg group and the control group (P<0.05). The EPDS scores of the 0.5mg/kg and 0.8mg/kg groups at 24h and 72h after surgerywere lower than those of the 0.2mg/kg group and the control group (P<0.05). The 0.5mg/kg group and 0.8mg/kg group had shorter first ambulation time, first anal exhaust time, and lactation onset time compared to the 0.2mg/kg group and the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the 0.5mg/kg group and 0.8mg/kg group, as well as in the VAS scores at 2, 4, 12, and 24 hours after surgery, NE, Cor, and ACTH scores at 24 hours after surgery, EPDS scores at 24 and 72 hours after surgery, first ambulation time, first anal exhaust time, and lactation start time (P>0.05). Conclusion:Different doses of ketamine combined with sufentanil have shown good efficacy in patient-controlled analgesia for cesarean section mothers, with advantages such as relieving postoperative pain and improving postpartum depression, is recommended to use 0.5mg/kg ketamine. |
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