Effects of esketamine-sufentanil for patient-controlled intravenous analgesia in women following cesarean section: A randomized clinical trial.

Abstract

<h4>Background</h4>Postoperative pain following cesarean section can cause maternal anxiety, limited ambulation, and even postpartum depression. In this study, we aimed to investigate the effects of esketamine for postoperative patient-controlled intravenous analgesia in women following cesarean section.<h4>Methods</h4>One hundred women were randomly assigned to two groups. The esketamine group received 1 mg⋅kg^-1⋅d^-1 of esketamine +1 µg⋅kg^-1⋅d^-1 of sufentanil for intravenous postoperative analgesia, and the control group received 1 µg⋅kg^-1⋅d^-1 of sufentanil for intravenous analgesia. The primary outcome was the pain intensity during the postoperative 24 h, and it was assessed using a visual analog scale (VAS). The secondary outcomes included hemodynamic parameters, total consumption of analgesics, blood loss, and drug-related side effects (hypotension, hypertension, bradycardia, nausea, and vomiting).<h4>Results</h4>The VAS scores at rest were lower in the esketamine group than in the control group during the postoperative 6 h-24 h (<i>p</i> < 0.05), and the VAS scores at cough in the esketamine group were lower during the postoperative 4 h-24 h (<i>p</i> < 0.05). There were significant differences at blood loss during the postoperative 24 h (137.6 ± 33.0 vs 159.6 ± 41.3 mL, <i>p</i> = 0.004). Blood pressure and heart rate were greater in the esketamine group than in the control group during the postoperative 8 h-24 h (<i>p</i> < 0.05). The incidence of nausea and vomiting was significantly lower in the esketamine group than in the control group (4% vs 18%, <i>p</i> = 0.025).<h4>Conclusion</h4>This study indicated that esketamine not only improved postoperative pain but also reduced postpartum blood loss and the incidence of nausea and vomiting in women undergoing cesarean section (registration number: ChiCTR2400082094).<h4>Systematic review registration</h4>https://www.chictr.org.cn, Identifier ChiCTR2400082094.

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