Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section

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Oct 6, 2024 (publication date) through Aug 13, 2024

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.

World J Clin Cases. Oct 6, 2024; 12(28): 6195-6203
Published online Oct 6, 2024. doi: 10.12998/wjcc.v12.i28.6195

Table 1 Comparison of general and surgical characteristics among the three groups of pregnant women

Indicator	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	F/χ²	P value
Age (years, mean ± SD)	32 ± 4	33 ± 8	33 ± 4	0.988	0.374
BMI (kg/m², mean ± SD)	28.8 ± 3.3	28.9 ± 2.9	29.0 ± 2.8	0.159	0.853
Preoperative Hb (g/L, mean ± SD)	115 ± 8	115 ± 8	114 ± 7	0.055	0.946
Parity, n (%)				1.317	0.859
Primipara	25 (25.8)	29 (29.9)	28 (28.6)
Multipara	62 (63.9)	61 (62.9)	59 (60.2)
Grand multipara	10 (10.3)	7 (7.2)	11 (11.2)
Education level, n (%)				1.712	0.789
Below college	21 (21.6)	21 (21.6)	24 (24.5)
College and undergraduate	64 (66.0)	67 (69.1)	67 (68.4)
Master and above	12 (12.4)	9 (9.3)	7 (7.1)
Blood loss (mL, mean ± SD)	372 ± 59	373 ± 59	361 ± 58	1.234	0.293
Operative time (min, mean ± SD)	37 ± 8	37 ± 8	36 ± 8	0.222	0.801

Hb: Haemoglobin.

Table 2 Comparison of Visual Analog Scale scores at different time points post-cesarean section among the three groups of pregnant women (scores, mean ± SD)

Time point	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	F/χ²	P value
Postoperative 6 hours	1.8 ± 0.4^a	1.9 ± 0.8^a	2.3 ± 0.6^b	22.358	< 0.001
Postoperative 12 hours	2.7 ± 0.7^a	2.6 ± 0.7^a	3.3 ± 1.2^b	15.599	< 0.001
Postoperative 24 hours	3.1 ± 1.0^a	2.7 ± 0.8^a^,^b	3.5 ± 1.2^b	17.220	< 0.001
Postoperative 48 hours	2.1 ± 0.6	2.1 ± 0.7^a	2.4 ± 1.1	4.498	0.012
Rescue rate, n (%)	15 (15.5)	14 (14.4)	27 (27.6)	6.705	0.035

^aP < 0.05 compared with control group.

^bP < 0.05 compared with low-dose group.

Table 3 Comparison of Edinburgh Postnatal Depression scale scores at different time points among the three groups of pregnant women (scores, mean ± SD)

Time point	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	F value	P value
Prenatal 1 day	7.5 ± 2.2	7.2 ± 2.3	7.3 ± 2.3	0.245	0.783
Postoperative 2 day	7.2 ± 2.2^a	7.5 ± 2.6^a	8.8 ± 3.4^b	8.331	< 0.001
Postoperative 7 day	7.3 ± 3.1^a	7.0 ± 2.9^a	9.1 ± 3.3^b	13.639	< 0.001
Postoperative 42 day	8.3 ± 3.1	8.1 ± 3.0	8.8 ± 3.6	1.158	0.316

^aP < 0.05 compared with control group.

^bP < 0.05 compared with low-dose group.

Table 4 Comparison of postpartum depression incidence at different time points among the three groups of pregnant women, n (%)

Time point	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	χ² value	P value
Postoperative 2 day	5 (5.1)^a	6 (6.2)^a	14 (14.3)^b	6.218	0.045
Postoperative 7 day	8 (8.2)^a	5 (5.1)^a	16 (16.3)^b	7.238	0.027
Postoperative 42 day	11 (11.3)	10 (10.3)	17 (17.3)	2.484	0.289

^aP < 0.05 compared with control group.

^bP < 0.05 compared with low-dose group.

Table 5 Comparison of Ramsay scores after intravenous injection of esketamine among the three groups of pregnant women (scores, mean ± SD)

Time point	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	F value	P value
Mediate injection	1.92 ± 0.28	1.89 ± 0.33	1.83 ± 0.37	1.47	0.23
5 minutes post-injection	3.4 ± 0.6^a	4.8 ± 0.4^a^,^b	1.8 ± 0.4^b	949.15	< 0.01
15 minutes post-injection	2.2 ± 0.5^a	3.6 ± 0.6^a^,^b	1.9 ± 0.3^b	355.18	< 0.01
Immediate postoperative	2.04 ± 0.20^a	2.08 ± 0.28^a	1.85 ± 0.39	17.25	< 0.01

^aP < 0.05 compared with control group.

^bP < 0.05 compared with low-dose group.

Table 6 Comparison of post-cesarean section recovery indicators among the three groups of pregnant women (hours, mean ± SD)

Time point	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	F value	P value
Time to first flatus	29 ± 6	28 ± 5	30 ± 5	1.950	0.144
Time to first bowel movement	66 ± 11	65 ± 11	66 ± 10	0.238	0.788
Time to ambulation	23.9 ± 3.1^a	23.8 ± 2.5^a	25.3 ± 3.0^b	8.088	< 0.001

^aP < 0.05 compared with control group.

^bP < 0.05 compared with low-dose group.

Table 7 Comparison of the incidence of adverse reactions after intravenous injection of ketamine in three groups, n (%)

Adverse reaction	Administration time	Low-dose group (n = 97)	How-dose group (n = 97)	Control group (n = 98)	χ² value	P value
Nausea & vomiting	0-2 h	2 (2.1)	2 (2.1)	3 (3.1)	0.278	0.870
Headache	0-2 h	0 (0)	2 (2.1)	0 (0)	4.048	0.132
Hallucination	0-2 h	2 (7.2)^a	9 (9.3)^a^,^b	0 (0)	8.949	0.011
Dizziness	0-2 h	7 (7.2)	7 (7.2)	2 (2.0)	3.368	0.186
Drowsiness	0-2 h	6 (10.3)^a	17 (17.5)^a^,^b	0 (0)	18.039	< 0.001
Diplopia	0-2 h	2 (8)^a	9 (9.3)^a^,^b	0 (0)	9.213	0.010
Shivering	0-2 h	5 (5.2)	3 (3.1)	6 (6.1)	1.022	0.600
Itching	0-2 h	0 (0)	3 (3.1)	2 (2.0)	2.851	0.240
Reaction delay	0-2 h	3 (3.1)	3 (3.1)	0 (0)	3.095	0.213

^aP < 0.05 compared with control group.

^bP < 0.05 compared with low-dose group.

Citation: Chen HZ, Gao Y, Li KK, An L, Yan J, Li H, Zhang J. Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section. World J Clin Cases 2024; 12(28): 6195-6203
URL: https://www.wjgnet.com/2307-8960/full/v12/i28/6195.htm
DOI: https://dx.doi.org/10.12998/wjcc.v12.i28.6195

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