艾司氯胺酮对剖宫产患者疼痛及炎性反应的影响

Effect of Pain and Inflammatory Response in Patients Undergoing Cesarean Section with Esketamine

摘要: 目的：艾司氯胺酮对剖宫产术患者疼痛及炎性反应的影响。方法：选取本院60例择期初次行剖宫产的女性患者，采用随机数字表法随机分为两组：对照组(C组)和艾司氯胺酮组(K组)。于手术结束后6 h、手术结束后12 h，手术结束后24 h，手术结束后48 h四个时间点评价两组患者静息和咳嗽视觉模拟评分(VAS)。分别于入手术室麻醉前，手术结束时、手术结束后24 h，手术结束后48 h四个时间点检测皮质醇(Cor)、白介素-6 (IL-6)、肿瘤坏死因子α (TNF-α)水平。结果：在术后12 h、术后24 h、术后48 h三个时间点中，与C组患者比较，K组患者静息、咳嗽VAS均降低(P < 0.05)；在手术结束时、术后24 h、术后48 h三个时间点中，与C组患者比较，K组患者的皮质醇的血浆浓度均明显降低(P < 0.05)；在手术结束时、术后24 h、术后48 h三个时间点中，与C组患者比较，K组患者的IL-6、TNF-α的血浆浓度均明显降低(P < 0.05)。结论：艾司氯胺酮可减轻剖宫产患者围术期疼痛和炎性反应。

Abstract: Objective: To investigate the effects of pain and inflammatory response in patients undergoing ce-sarean section with esketamine. Methods: 60 patients undergoing cesarean section in our hospital were selected and randomly divided into the control group (group C) and the esketamine group (group K) using the random number table method. The visual analogue score (VAS) of resting and coughing of patients was evaluated at four time points: 6 h, 12 h, 24 h and 48 h after the operation. Cortisol (Cor), interleukin-6 (IL-6) and tumor necrosis factor (TNF) were detected by ELISA at the anesthesia in the operating room, 24 h and 48 h after the operation. Results: Compared with group C, the patient coughing and resting VAS scores decreased at 12 h, 24 h, and 48 h after operation in group K (P < 0.05). Compared with group C, the Cor decreased in group K at the end, 24 h, 48 h after operation (P < 0.05). Compared with group C, the IL-6 and TNF-α decreased in group K at the end, 24 h, 48 h after operation (P < 0.05). Conclusions: Esketamine could relieve the pain and inflammatory response in patients undergoing cesarean section.