摘要

【摘要】
目的：探讨剖宫产术产妇应用艾司氯胺酮复合布托啡诺对其术后镇痛及心理状态的影响。

方法：于2020年1月-2023年1月采集病例资料入档，对象为医院收治的剖宫产术产妇，共计纳入80例，基于“随机数字表法”分组，组别为对照组（实行布托啡诺自控静脉镇痛）与观察组（实行布托啡诺复合艾司氯胺酮自控静脉镇痛）；观察对比两组术后镇痛效果、焦虑抑郁状态、睡眠质量、产后恢复情况。

结果：观察组术后4h、8h、24h、48h时视觉模拟评分法（VAS）评分显著低于对照组（P<0.05）；产后，两组爱丁堡产后抑郁量表（EPDS）评分、广泛性焦虑障碍量表7（GAD-7）评分均呈不同程度降幅，且观察组降幅更大（P<0.05）；观察组产后匹兹堡睡眠质量指数（PSQI）评分明显低于对照组（P＜0.05）观察组术后膀胱恢复排尿、首次肛门排气、初乳时间较对照组更短（P＜0.05）。

结论：对于剖宫产术产妇应用艾司氯胺酮复合布托啡诺可增强术后镇痛效果，缓解产妇疼痛程度，并有效改善产后负性情绪，以改善睡眠质量，降低产后抑郁发生。

关键词：【关键词】艾司氯胺酮；布托啡诺；剖宫产术；镇痛效果；产后焦虑抑郁

ABSTRACT

Abstract:
Objective: To explore the effects of using Esketamine combined with Butorphanol on postoperative pain relief and psychological status of postpartum women undergoing cesarean section. Method: From April 2020 to April 2023, case data were collected and included in the file. The subjects were cesarean section women admitted to the hospital, with a total of 80 cases included. They were divided into two groups based on the "random number table" method: the control group (implementing butorphanol controlled intravenous analgesia) and the observation group (implementing butorphanol combined with esketamine controlled intravenous analgesia); Observe and compare the postoperative analgesic effect, anxiety and depression status, sleep quality, and postpartum recovery between the two groups. Result: The visual analogue scale (VAS) score in the observation group was significantly lower than that in the control group at 4, 8, 24, and 48 hours after surgery (P<0.05); After childbirth, the Edinburgh Postpartum Depression Scale (EPDS) and Generalized Anxiety Disorder Scale 7 (GAD-7) scores of both groups showed varying degrees of decline, and the observed group showed a greater decrease (P<0.05); The postpartum Pittsburgh Sleep Quality Index (PSQI) score of the observation group was significantly lower than that of the control group (P<0.05). The observation group had shorter postoperative bladder recovery, first anal discharge, and colostrum time compared to the control group (P<0.05).

Conclusion  : The application of Esketamine combined with butorphanol in cesarean section women can enhance the postoperative analgesic effect, alleviate the degree of pain, effectively improve postpartum negative emotions, improve sleep quality, and reduce the occurrence of postpartum depression.

Key words: Keywords: Esketamine; Butorphanol; Cesarean section; Analgesic effect; Postpartum anxiety and depression