Clinical Study On Esketamine Hydrochloride Injection In The Management Of Acute Pain After Gynecological Surgery

Objective: At present,there are great differences in the dosage and medication plan of Esketamine in different regions and countries.Therefore,in order to better guide clinical medication for the benefit of the majority of patients,we designed this randomized controlled study to explore the analgesic effect and safety evaluation of Esketamine in acute pain after gynecological surgery in adults in China.Methods: The patients who received gynecological surgery in our hospital from April 2022 to July 2022 were selected as the study subjects.They were divided into three groups according to the method of random number table: the test group SK1,SK2 and the control group,with 55 cases in each group.The test group SK1 received a single intravenous injection of0.5mg/kg of Esketamine injection before skin incision;The test group SK2 received a single intravenous infusion of 0.5mg/kg of Esketamine injection before skin incision,and continuous intravenous infusion of 0.25mg/kg/h of Esketamine injection during the operation,while the control group received the same dose of saline during the perioperative period.The NRS pain score,anesthesia recovery time,preoperative and postoperative anxiety and depression,postoperative cognitive function changes,postoperative adverse events and postoperative delirium were compared among the three groups.Results: There was no difference in NSR values between SK1 group and SK2 group at different time points(P> 0.05),and the NSR values of patients in both groups at different time points were significantly lower than those in group C(P<0.05);There was no difference in preoperative HAD among the three groups(P>0.05).The HAD values of patients in both SK1 and SK2 groups were significantly lower than those in Group C at 48 hours after surgery(P<0.05).There was no difference in the value of HAD at 48 hours after operation between group SK1 and group SK2(P>0.05);There was no difference in MMSE between the three groups before and 48 hours after operation(P>0.05);There was no difference in the incidence of postoperative anesthesia related complications among the three groups of patients(P>0.05).Conclusion: Esketamine used in gynecological surgery can significantly reduce the postoperative pain score of patients,reduce the postoperative pain of patients,and do not increase the risk of postoperative cognitive dysfunction and delirium.The reasonable use of Esketamine during perioperative period is safe and reliable.