PDF(Pubmed)
Abstract：
UNASSIGNED: We aimed to evaluate the effect of intravenous esketamine combined with dexmedetomidine as supplemental analgesia in reducing intraoperative visceral pain during elective cesarean section under combined spinal-epidural anesthesia (CSEA).
UNASSIGNED: A total of 269 parturients scheduled for elective cesarean section under CSEA between May 2023 and August 2023 were assessed. The parturients were randomly allocated to receiving either intravenous infusion of 0.3-mg/kg esketamine combined with 0.5-μg/kg dexmedetomidine (group ED, n=76), 0.5-μg/kg dexmedetomidine (group D, n=76), or normal saline (group C, n=76) after umbilical cord clamping. The primary outcome was intraoperative visceral pain. Secondary outcomes included the visual analog scale (VAS) score for pain evaluation and other intraoperative complications.
UNASSIGNED: The incidence of visceral pain was lower in group ED [9 (12.7%)] than in group D [32 (43.8%)] and group C [36 (48.6%), P <0.0001]. The VAS score was also lower in group ED when exploring abdominal cavity [0 (0), P <0.0001] and suturing the muscle layer [0 (0), P =0.036]. The mean arterial pressure was higher in group D [83 (9) mmHg] and group ED [81 (11) mmHg] than in group C [75 (10) mmHg, P <0.0001] after solution infusion. The heart rate after infusion of the solution was lower in group D [80 (12) bpm] than in group C [86 (14) bpm] and group ED [85 (12) bpm, P = 0.016]. The incidence of transient neurologic or mental symptoms was higher in group ED compared to group C and group D (76.1% vs 18.9% vs 23.3%, P<0.0001).
UNASSIGNED: During cesarean section, 0.3-mg/kg esketamine combined with 0.5-μg/kg dexmedetomidine can alleviate visceral traction pain and provide stable hemodynamics. Parturients receiving this regimen may experience transient neurologic or mental symptoms that can spontaneously resolve at the end of the surgery.
Some parturients endure experience indescribable pain and discomfort during fetal delivery. Esketamine combined with dexmedetomidine can alleviate this pain during cesarean section under combined spinal-epidural anesthesia. However, after intravenous injection of esketamine and dexmedetomidine, the parturients may experience nightmares, dizziness, hallucinations, and drowsiness, etc.
UNASSIGNED: A total of 269 parturients scheduled for elective cesarean section under CSEA between May 2023 and August 2023 were assessed. The parturients were randomly allocated to receiving either intravenous infusion of 0.3-mg/kg esketamine combined with 0.5-μg/kg dexmedetomidine (group ED, n=76), 0.5-μg/kg dexmedetomidine (group D, n=76), or normal saline (group C, n=76) after umbilical cord clamping. The primary outcome was intraoperative visceral pain. Secondary outcomes included the visual analog scale (VAS) score for pain evaluation and other intraoperative complications.
UNASSIGNED: The incidence of visceral pain was lower in group ED [9 (12.7%)] than in group D [32 (43.8%)] and group C [36 (48.6%), P <0.0001]. The VAS score was also lower in group ED when exploring abdominal cavity [0 (0), P <0.0001] and suturing the muscle layer [0 (0), P =0.036]. The mean arterial pressure was higher in group D [83 (9) mmHg] and group ED [81 (11) mmHg] than in group C [75 (10) mmHg, P <0.0001] after solution infusion. The heart rate after infusion of the solution was lower in group D [80 (12) bpm] than in group C [86 (14) bpm] and group ED [85 (12) bpm, P = 0.016]. The incidence of transient neurologic or mental symptoms was higher in group ED compared to group C and group D (76.1% vs 18.9% vs 23.3%, P<0.0001).
UNASSIGNED: During cesarean section, 0.3-mg/kg esketamine combined with 0.5-μg/kg dexmedetomidine can alleviate visceral traction pain and provide stable hemodynamics. Parturients receiving this regimen may experience transient neurologic or mental symptoms that can spontaneously resolve at the end of the surgery.
Some parturients endure experience indescribable pain and discomfort during fetal delivery. Esketamine combined with dexmedetomidine can alleviate this pain during cesarean section under combined spinal-epidural anesthesia. However, after intravenous injection of esketamine and dexmedetomidine, the parturients may experience nightmares, dizziness, hallucinations, and drowsiness, etc.
摘要：
■我们的目的是评估静脉应用艾氯胺酮联合右美托咪定辅助镇痛在腰硬联合麻醉（CSEA）下择期剖宫产术中内脏疼痛的减轻效果。
■对2023年5月至2023年8月期间计划在CSEA下进行选择性剖宫产的269名产妇进行了评估。将产妇随机分配至接受静脉输注0.3-mg/kg艾氯胺酮联合0.5-μg/kg右美托咪定（ED组，n=76),0.5-μg/kg右美托咪定（D组，n=76),或生理盐水（C组，脐带夹紧后n=76)。主要结果是术中内脏疼痛。次要结果包括疼痛评估的视觉模拟量表（VAS）评分和其他术中并发症。
ED组[9(12.7%)]的内脏痛发生率低于D组[32(43.8%)]和C组[36(48.6%),P<0.0001]。ED组探查腹腔时VAS评分也较低[0(0),P<0.0001]和缝合肌肉层[0（0），P=0.036]。D组平均动脉压[83(9)mmHg]和ED组[81(11)mmHg]高于C组[75(10)mmHg,溶液输注后P<0.0001]。D组输液后心率[80(12)bpm]低于C组[86(14)bpm]和ED组[85(12)bpm,P=0.016]。与C组和D组相比，ED组的短暂性神经或精神症状的发生率更高（76.1％vs18.9％vs23.3％，P<0.0001)。
■剖宫产时,0.3-mg/kg艾氯胺酮联合0.5-μg/kg右美托咪定可减轻内脏牵引痛并提供稳定的血流动力学。接受该方案的产妇可能会经历短暂的神经或精神症状，这些症状可以在手术结束时自发缓解。
一些产妇在胎儿分娩过程中忍受难以形容的疼痛和不适。依维他明复合右美托咪定可减轻腰-硬联合麻醉剖宫产术中的疼痛。然而,静脉注射艾氯胺酮和右美托咪定后，产妇可能会经历噩梦，头晕,幻觉,和困倦,等。
■对2023年5月至2023年8月期间计划在CSEA下进行选择性剖宫产的269名产妇进行了评估。将产妇随机分配至接受静脉输注0.3-mg/kg艾氯胺酮联合0.5-μg/kg右美托咪定（ED组，n=76),0.5-μg/kg右美托咪定（D组，n=76),或生理盐水（C组，脐带夹紧后n=76)。主要结果是术中内脏疼痛。次要结果包括疼痛评估的视觉模拟量表（VAS）评分和其他术中并发症。
ED组[9(12.7%)]的内脏痛发生率低于D组[32(43.8%)]和C组[36(48.6%),P<0.0001]。ED组探查腹腔时VAS评分也较低[0(0),P<0.0001]和缝合肌肉层[0（0），P=0.036]。D组平均动脉压[83(9)mmHg]和ED组[81(11)mmHg]高于C组[75(10)mmHg,溶液输注后P<0.0001]。D组输液后心率[80(12)bpm]低于C组[86(14)bpm]和ED组[85(12)bpm,P=0.016]。与C组和D组相比，ED组的短暂性神经或精神症状的发生率更高（76.1％vs18.9％vs23.3％，P<0.0001)。
■剖宫产时,0.3-mg/kg艾氯胺酮联合0.5-μg/kg右美托咪定可减轻内脏牵引痛并提供稳定的血流动力学。接受该方案的产妇可能会经历短暂的神经或精神症状，这些症状可以在手术结束时自发缓解。
一些产妇在胎儿分娩过程中忍受难以形容的疼痛和不适。依维他明复合右美托咪定可减轻腰-硬联合麻醉剖宫产术中的疼痛。然而,静脉注射艾氯胺酮和右美托咪定后，产妇可能会经历噩梦，头晕,幻觉,和困倦,等。
