Dezocine versus esketamine as postoperative analgesia in women undergoing cesarean section

Wei Qiao, Xiaoxiao Zhang

Abstract

The objective of this was to investigate the effect of esketamine as a postoperative analgesia in women undergoing caesarean section. A total of 134 patients were divided into two groups: 112 received esketamine and 22 received dezocine, based on their voluntary choice of analgesic drugs for patient-controlled intravenous analgesia (PCIA). The postoperative analgesic effects were compared between the two groups. The results showed that the visual analogue scale (VAS) scores at 12 and 24 hours post-operation were significantly lower in the esketamine group than in the dezocine group (P<0.05). Additionally, the time to first anal exhaust was earlier in the esketamine group (P<0.05), while there were no significant differences in the time to first ambulation or urination between the two groups (P>0.05). There was no significant difference in adverse reactions between the groups (P>0.05). The Edinburgh postnatal depression scale (EPDS) scores at 1 and 3 days after surgery were significantly higher than the preoperative scores in both groups (P<0.05); however, the EPDS scores were significantly lower in the esketamine group compared to the Dezocine group (P<0.05). We conclude that esketamine provides effective postoperative pain relief in women undergoing caesarean section patients without increasing adverse reactions, while it promotes recovery and reduces postpartum depression

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References

Alalfy M, Yehia A and Samy A. Routine cervical dilatation

at caesarean section and its influence on postoperative

pain and complications in obese women: a doubleblind randomized controlled trial. J Matern Fetal

Neonatal Med. 2021;34(12):1906-1913.

Marcus H, Koppert W, Schug S, Meissner W, Trampisch

HJ and Maier C. Quality of pain treatment after

caesarean section: Results of a multicentre cohort

study. Eur J Pain. 2015;19(7):929-939.

Shen D, Xu Y, Wu H, Wang Y, Zhang L, Zhang W, Zhou

J and Fan J. Acute postoperative pain is correlated

with the early onset of postpartum depression after

cesarean section: a retrospective cohort study. J

Anesth. 2020;34(4):607-612.

Babazade R, Greenblatt L, Callaghan WM, Lubetkin E,

Hong D, McNamara M and Gyamfi Bannerman C.

Acute postcesarean pain is associated with in-hospital

exclusive breastfeeding, length of stay, and postpartum depression. J Clin Anesth. 2020;62:109697.

Irwin R and Tan T. Evaluation of the impact of enhanced

recovery after surgery protocol implementation on

maternal outcomes following elective caesarean

delivery. Int J Obstet Anesth. 2020;43:17.

Macones GA, Caughey AB, Wood SL, Wrench IJ, Huang

J, Wilson MJ, Balki M, Batchelor A, Boelig RC,

Cortez GM, Kern-Goldberger AR, Weibel S, Ramin

S, Warren C, Martin S, D’Alton M, Khoo S, Walters

S, Meagher L, Tolcher M, Oladapo O, Howell EA,

George RB and Carusi D. Guidelines for

postoperative care in cesarean delivery: Enhanced

Recovery After Surgery (ERAS) Society

recommendations (part 3). Am J Obstet Gynecol.

;221(3):247.e1-247.e9.

Kasper S, Rush AJ, Kornstein S, Thase ME, Luan R, Cui

C, Tong Q, Li H and Esketamine Global Advisory

Panel. Practical recommendations for the

management of treatment-resistant depression with

esketamine nasal spray therapy: Basic science,

evidence-based knowledge and expert guidance.

World J Biol Psychiatry. 2021;22(6):468-482.

Maxwell C. Sensitivity and accuracy of the visual analogue

scale: a psycho-physical classroom experiment. Br J

Clin Pharmacol. 1978;6(1):15-24.

Glaze R and Cox JL. Validation of a computerised version

of the 10-item (self-rating) Edinburgh Postnatal

Depression Scale. J Affect Disord. 1991;22(1-2):73-

Zhang RY, Wang XY, Li Y, Jiang CC, Wang RH, Zhao ZY

and Sun YY. [Clinical random trial of thumbtack

needling therapy for analgesia after cesarean section].

Zhen Ci Yan Jiu. 2022;47(8):719-723.

Shelke A and Chakole S. A review on risk factors of

postpartum depression in India and its management.

Cureus. 2022;14(9).

Ayisire OE, Oyagbemi AA, Ilemobade AO, Bello OT,

Oladunmade OM and Ogungbemi AO. The use of

cannabis and its effects on postpartum depression.

Cureus. 2022;14(8).

Craven R. Ketamine. Anaesthesia. 2007;62 Suppl 1:48-53.

Morgan CJ, Curran HV and Independent Scientific

Committee on Drugs. Ketamine use: a review.

Addiction. 2012;107(1):27-38.

Wang Q, Zhang Y, Li C, Liu P, Xu Q and Zhu Y. A study

on the preventive effect of esketamine on postpartum

depression (PPD) after cesarean section. Comput

Math Methods Med. 2022;2022:1524198.

Wang Y, Liu Z, Fan H, Chen Z, Li S and Wang J. Effect of

low-dose esketamine on pain control and postpartum

depression after cesarean section: a retrospective

cohort study. Ann Palliat Med. 2022;11(1):45-57.

Jawad MY, Arshad U, Chaudhry M, Saeed S, Ahmed M

and Ullah K. The therapeutic role of ketamine and

esketamine in treating psychopathological domains of

depression. Neuropharmacology. 2022;223:109299.

Shoib S, Qayoom I, Mushtaq R and Bhat F. Esketamine: A

quick-acting novel antidepressant without the

disadvantages of ketamine. Horm Mol Biol Clin

Investig. 2022.

Lin YM, Qu MM, Wang YX, Wu JJ, Tian XY, Zhang JL

and Lin LB. An opioid receptor-independent mechanism

underlies motility dysfunction and visceral

hyperalgesia in opioid-induced bowel dysfunction.

Am J Physiol Gastrointest Liver Physiol. 2021;320(6).

Alipoor M, Moghaddam MG, Rezai M and Hassanpour M.

The effect of ketamine on preventing postpartum

depression. J Med Life. 2021;14(1):87-92.

Bateman RM, Scales DC, Forster AJ, Godin J and Hebert

PC. 36th International Symposium on Intensive Care

and Emergency Medicine: Brussels, Belgium. 15-18

March 2016. Crit Care. 2016;20(Suppl 2):94.

Xu Y, Zhang F, Luo Y and Ma L. Single bolus low-dose of

ketamine does not prevent postpartum depression: a

randomized, double-blind, placebo-controlled,

prospective clinical trial. Arch Gynecol Obstet.

;295(5):1167-1174.

Morris LS, Costi S, Tan A, Stern ER, Charney DS and

Murrough JW. Ketamine normalizes subgenual

cingulate cortex hyperactivity in depression.

Neuropsychopharmacology. 2020;45(6):975-981.

Miksic S, Zecic A, Butorac K, Mavrinac M and Roje D.

Positive effect of breastfeeding on child development,

anxiety, and postpartum depression. Int J Environ Res

Public Health. 2020;17(8).

Stewart DE and Vigod SN. Postpartum depression:

Pathophysiology, treatment, and emerging

therapeutics. Annu Rev Med. 2019;70:183-196.

Cook J and Halaris A. Adjunctive dopaminergic

enhancement of esketamine in treatment-resistant

depression. Prog Neuropsychopharmacol Biol

Psychiatry. 2022;119:110603

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