Observation On Analgesic Effect Of Esketamine After Cesarean Section And Prevention Of Postpartum Depression

Objective: Pregnant women after cesarean section not only need pain relief and sedation,but also need to prevent and treat the occurrence of depression.Esketamine is a drug that can meet these two needs.This article aims to explore the postoperative analgesic effect,prevention,and treatment of postpartum depression of women undergoing cesarean section using Esketamine.Methods 120 women aged 20-39 years old who underwent elective cesarean section were randomly divided into two groups(n=60): Esketamine(group E)and control group(group F).The scores of Edinburgh Postnatal Depression Scale(EPDS)and Pittsburgh Sleep Quality Index(PSQI)were recorded before operation(T0).In group E,0.25 mg/kg of Esketamine was given intravenously after the umbilical cord was cut,and the infusion was completed within30 seconds.Group F was given the same dose of normal saline intravenously.The formula of PCIA analgesic solution for the two groups of puerperas after operation:group E: Esketamine 1mg/kg+butorphanol 0.15mg/kg+Kaifen 2mg/kg+azasetron 10mg;Group F: Butorphanol 0.15 mg/kg+Kaifen 2 mg/kg+azasetron 10 mg,all mixed with normal saline to a total of 100 ml.The scores of visual analogue scale(VAS score)and sedation(Ramsay)during rest and uterine contraction were recorded at 12 hours(T1),24 hours(T2)and 48 hours(T3)after operation,and the use of postoperative analgesia pump was recorded.PSQI and EPDS scores of the two groups were followed up at 3days(T4),1 week(T5)and 6 weeks(T6)after operationResults:There was no statistical difference in age,BMI,ASA and other general data between the two groups(P>0.05).Compared with group F,the VAS score of group E was generally reduced(P<0.05),and the effective press times were significantly reduced.Compared with group F,the PSQI and EPDS of group E decreased(P>0.05).Conclusion : Intraoperative intravenous infusion of small dose of Esketamine and continuous patient-controlled intravenous analgesia(PCIA)pump infusion of Esketamine can effectively reduce the anxiety and pain of the pregnant women during operation,improve the sleep of the pregnant women,reduce the score of postpartum depression,and do not increase the incidence of adverse reactions.