Low-dose esketamine with sufentanil for postcesarean analgesia in women with gestational diabetes mellitus: a prospective, randomized, double-blind study

被引:6
作者
Han, Tao [1 ]
Chen, Qin [1 ]
Huang, Jie [1 ]
Zhang, Jie [1 ]
Li, Aiyuan [1 ]
Xu, Wei [1 ]
Peng, Zheming [1 ]
Li, Zhen [1 ]
Chen, Liang [1 ]
机构
[1] Hunan Prov Maternal & Child Hlth Care Hosp, Dept Anesthesiol, Changsha, Peoples R China
来源
FRONTIERS IN ENDOCRINOLOGY | 2023年 / 14卷
关键词
gestational diabetes; cesarean delivery; intravenous patient-controlled analgesia; esketamine; prospective study; POSTOPERATIVE PAIN; DELIVERY ANALGESIA; S-KETAMINE; BENEFITS; SURGERY;
D O I
10.3389/fendo.2023.1202734
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Pregnant women with gestational diabetes mellitus (GDM) require more analgesics after cesarean delivery than those who do not have GDM. Uncontrolled pain following cesarean delivery is a major problem in women with GDM. We investigate the efficacy of low-dose esketamine combined with sufentanil intravenous patient- controlled analgesia (PCA)for postcesarean analgesia in women with GDM. Methods: One hundred forty pregnant women with GDM were enrolled participate in this randomized controlled trial and were randomized into two groups ( 70 in each group). The esketamine ( S) group was given esketamine +sufentanil + ondansetron, and the control (C) group was given sufentanil +ondansetron. The primary outcome is sufentanil consumption at 24 hours postoperatively, the secondary outcomes are sufentanil consumption at 6 hours postoperatively, pain scores at 6, 24 and 48 hours postoperatively. Results: Compared with group C, group S had significantly lower sufentanil consumption at 6 and 24 hours postoperatively (P= 0.049 and P<0.001), significantly lower activities VAS(pain during activities)scores at 6 hours postoperatively, rest and activities VAS (pain at rest and pain during activities) scores at 24 hours postoperatively, and activities VAS scores at 48 hours postoperatively( P=0.022, P =0.002, P=0.001 and P=0.007). Compared to group C, the time to bowel function return was significantly shorter in group S. There was no significant difference in rest VAS (pain at rest) scores at 6 and 48 hours postoperatively (P>0.05). The time to first lactation was not significantly different between the two groups (P>0.05). There was no significant difference in neonatal neurobehavioral scores between the two groups (P>0.05). Conclusion: Compared to sufentanil PCA, adding low dose of esketamine significantly reduced the consumption of sufentanil while providing equally effective post cesarean analgesia in the patients with gestational diabetes.
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页数:8
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