摘要
Abstract
Objective:To observe the clinical effect of Esketamine on patient-controlled intravenous analgesia(PCIA)after laparoscopic hysterectomy.Method:A total of 90 patients who underwent elective laparoscopic total hysterectomy from May 2021 to June 2022 in Dongfeng General Hospital of Sinopharm were selected and randomly divided into Sufentanil group(group S),low-dose Esketamine group(group E1)and high-dose Esketamine group(group E2),with 30 cases in each group.The postoperative analgesia regimen of the group S,Sufentanil 100 μg + Tropisetron 4 mg;group E1,Sufentanil 100 μg + Esketamine 80 mg + Tropisetron 4 mg;group E2,Sufentanil 100 μg + Esketamine 150 mg + Tropisetron 4 mg.Visual analog scale(VAS)scores,Ramsay sedation scores at 4,8,12,24,and 48 h after surgery,total number of patient-controlled analgesia(PCA)compressions and total dosage of Sufentanil were recorded in three groups.The occurrence of postoperative adverse reactions and patients with chronic pain 3 and 6 months after surgery were recorded.Result:There were no significant differences in VAS scores and Ramsay sedation scores at 4,8,12,24 and 48 h after surgery in three groups(P>0.05).Compared with group S,the total dosage of Sufentanil and the total number of PCA within 48 h in group E1 and group E2 were significantly less,the differences were statistically significant(P<0.05),but there were no statistical significance between group E1 and group E2(P>0.05).Compared with the group S,the rates of patients with chronic pain in the 3rd and 6th month after surgery in the group E1 and group E2 were significantly lower,the differences were statistically significant(P<0.05),while there were no statistically significant differences between the group E1 and group E2(P>0.05).The incidence of postoperative adverse reactions to nausea and vomiting in group E1 was lower than those in group E2 and group S,the differences were statistically significant(P<0.05),but there were no statistically significant differences between group E2 and group S(P>0.05).Conclusion:Sufentanil combined with low-dose Esketamine for PCIA can produce a better analgesic effect on acute pain,reduce the total amount of postoperative opioids and the incidence of adverse reactions,and reduce the occurrence of postoperative chronic pain.关键词
舒芬太尼/艾司氯胺酮/腹腔镜下全子宫切除术/术后镇痛Key words
Sufentanil/Esketamine/Laparoscopic total hysterectomy/Postoperative analgesia
