Postoperative Analgesic Effect of Esketamine

Epidural Esketamine and Morphine for Postoperative Analgesia After Caesarean Delivery: A Pilot Study

The aim of this study was to determine whether the addition of esketamine to morphine would improve postoperative analgesia after caesarean section.

Parturients who planned for a caesarean delivery using combined spinal-epidural anaesthesia with a request for postoperative anaesthesia were randomly divided into four groups (A, B, C and D). When the surgery was completed, the parturients in groups A, B, C and D were administered 2 mg morphine, 0.25mg/kg of esketamine, 0.25mg/kg of esketamine plus 2 mg morphine sulfate and 0.25mg/kg of esketamine plus 1 mg morphine through the epidural catheters, respectively. The postoperative pain at rest, pain with movement, the number of rescue analgesics and adverse effects were evaluated for 48 h after caesarean delivery.

Inclusion Criteria:

• nulliparous parturients who scheduled for elective caesarean delivery under spinal-epidural anaesthesia;
• parturients who had requested postoperative analgesia;
• parturients aged between 20-35 years old;
• parturients who had a full-term pregnancy;
• parturients who were identified as having a singleton pregnancy; and
• parturients who were categorised as having an American Society of Anaesthesiologists (ASA) physical status

Exclusion Criteria:

• parturients with severe internal, surgical or obstetric comorbidities (including spinal deformities, hypertension, placental abruption, cholestasis in pregnancy, asthma, heart disease and abnormal coagulation parameters)
• parturients with a known allergy to the drugs used in this study
• parturients with severe mental illness who could not comply with doctors' instructions
• parturients with chronic pain syndrome, which is defined as pain that persists for a period longer than 3 months