The Efficacy of Low-Dose Esketamine and Butorphanol in Treating Depression and Pain After Cesarean Section

Abstract

Objective: To explore the efficacy of combining low-dose esketamine with butorphanol in treating depression and pain following cesarean section. Methods: 100 cases of elective cesarean section were selected and randomly assigned into two groups in a 1:1 ratio. All parturients who fulfilled the inclusion criteria received spinal anesthesia, maintaining the anesthesia level at T6. In the esketamine group, the dosage regimen comprised esketamine 0.5 mg/kg and butorphanol 10 mg, diluted with 0.9% sodium chloride injection to 100 mL. The control group received butorphanol 10 mg, diluted similarly. Analgesia in both groups commenced after cutting the umbilical cord, with a loading volume of 2 mL, a background infusion dose set to 2 mL/h, and patient-controlled analgesia at 2 mL with an effective interval time of 30 minutes. The main indicators included the maternal burnout scale (MBS) and numerical rating scale (NRS) for pain to assess postpartum depression and pain after surgery. Results: No significant differences were observed in MBS scores between the two groups on postoperative days 1 to 9 (P > 0.05). Postpartum depression was not detected in either group. Pain NRS scores at 24 and 48 hours after surgery, including incision and uterine contraction pain, showed no significant differences between the two groups (P > 0.05). Tramadol rescue was not administered to any patients in either group. Additionally, no adverse reactions requiring drug intervention occurred in either group. Conclusion: This study concluded that the combination of low-dose esketamine with butorphanol did not further optimize the analgesic effect of butorphanol but significantly improved postpartum depression after cesarean section. Further research is needed to investigate the impact of the ketamine postoperative analgesia regimen on postpartum analgesia and depression.