AUTHOR=Zhao Yanping , Liu Lin , Hou Yi , Fan Jiaming 

TITLE=Effects of esketamine–sufentanil for patient-controlled intravenous analgesia in women following cesarean section: A randomized clinical trial

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1579633

DOI=10.3389/fphar.2025.1579633

ISSN=1663-9812

ABSTRACT=BackgroundPostoperative pain following cesarean section can cause maternal anxiety, limited ambulation, and even postpartum depression. In this study, we aimed to investigate the effects of esketamine for postoperative patient-controlled intravenous analgesia in women following cesarean section.MethodsOne hundred women were randomly assigned to two groups. The esketamine group received 1 mg⋅kg-1⋅d-1 of esketamine +1 µg⋅kg-1⋅d-1 of sufentanil for intravenous postoperative analgesia, and the control group received 1 µg⋅kg-1⋅d-1 of sufentanil for intravenous analgesia. The primary outcome was the pain intensity during the postoperative 24 h, and it was assessed using a visual analog scale (VAS). The secondary outcomes included hemodynamic parameters, total consumption of analgesics, blood loss, and drug-related side effects (hypotension, hypertension, bradycardia, nausea, and vomiting).ResultsThe VAS scores at rest were lower in the esketamine group than in the control group during the postoperative 6 h–24 h (p < 0.05), and the VAS scores at cough in the esketamine group were lower during the postoperative 4 h–24 h (p < 0.05). There were significant differences at blood loss during the postoperative 24 h (137.6 ± 33.0 vs 159.6 ± 41.3 mL, p = 0.004). Blood pressure and heart rate were greater in the esketamine group than in the control group during the postoperative 8 h–24 h (p < 0.05). The incidence of nausea and vomiting was significantly lower in the esketamine group than in the control group (4% vs 18%, p = 0.025).ConclusionThis study indicated that esketamine not only improved postoperative pain but also reduced postpartum blood loss and the incidence of nausea and vomiting in women undergoing cesarean section (registration number: ChiCTR2400082094).Systematic Review Registrationhttps://www.chictr.org.cn, Identifier ChiCTR2400082094