艾司氯胺酮不同给药时点对剖宫产产妇情绪状态及镇痛效果的影响

Objective To investigate the effects of different administration timing of esketamine on psychological emotion, analgesia management and clinical safety of patients undergoing cesarean section. Methods A total of 129 primiparas who underwent cesarean section in the department of obstetrics of Mianyang Central Hospital from June 2023 to June 2025 were selected as the subjects of this study. The subjects were divided into three groups according to the random number table method, each group had 43 people, and the three groups adopted different intervention methods. The pain degree, the degree of stress response of the organism, postpartum depression situation were compared at each time point in each group; the incidence of adverse reactions in each group was counted and the total incidence of adverse reactions between groups was compared. Results The mean Visual Analogue Scale(VAS) scores at postpartum 6 h, 12 h and 24 h in group C were significantly lower than those in groups A and B(P<0.05), the VAS scores in each group were on the rise within 12 h postpartum, and the VAS scores at 24 h postpartum showed a downward trend in each group. At postpartum 1 day, stress indicators in groups A and B were significantly higher than before the operation(P<0.05), and serum Cor, plasma E in group C were significantly higher than before the operation(P<0.05). At postpartum 1 day, serum Cor, plasma E and plasma NE in group C were significantly lower than those in groups A and B(P<0.05). The mean scores of Edinburgh Postnatal Depression Scale(EPDS) at postpartum 42 d were significantly lower than those at postpartum 7 d in each group(P<0.05), and the mean scores of EPDS at postpartum 7 d and 42 d in group C were significantly lower than those in groups A and B(P<0.05). Conclusion The administration of esketamine during cesarean section combined with esketamine PCIA after the operation can effectively reduce the pain and stress response of the patient during the perioperative period, and can also reduce the risk of postpartum depression in patients, and this scheme has a good safety, which is worth clinical application.