Discussion
gestational diabetes, gastrointestinal adverse, breast milk, pain, hyperglycemia, dizziness, GDM, hallucinations, hypertension, nausea, vomiting
GESTATIONAL DIABETES, ADVERSE EFFECT, GDM, HYPERGLYCEMIA, ABNORMAL THYROID, COMPLICATED PREGNANCIES, HYPERTENSION
This randomized controlled trial evaluated the postoperative analgesic regimen for GDM women undergoing cesarean delivery. Our results showed that low-dose esketamine combined with sufentanil PCA in group S not only reduced the amount of sufentanil used at 6 and 24 hours postoperatively in GDM women undergoing cesarean delivery, but also significantly lowered the rest VAS scores at 24 hours postoperatively and significantly lowered the activities VAS scores at 6, 24, and 48 hours postoperatively compared with group C.Many previous studies (Esketamine, the dextroisomer of ketamine, has a higher affinity for NMDA receptors and U-opioid receptors and is used at only 1/2 the dose of ketamine. Previous studies (The presence of hyperglycemia in gestational diabetes patients undergoing surgery had an adverse effect on gastrointestinal function, and this study showed that the proportion of mothers in group S with bowel function return times <24h and 24-48h was significantly higher than that in group C. This result may be related to the fact that esketamine effectively relieved the adverse stress caused by pain, and that esketamine reduced the amount of sufentanil, thus controlling the resulting gastrointestinal adverse effects and facilitating the recovery of bowel function after surgery. However, we need to monitor more indicators related to gastrointestinal function to corroborate this result, and the specific mechanism needs to be further investigated.Postpartum lactation was mainly the result of the combined action of prolactin and lactogen, and the results of our study showed no significant difference in the time to the first lactation between the two groups. Consistent with the findings of a previous study (The incidence of nausea, vomiting, dizziness, and hallucinations in this study was not significantly different between the two groups. Consistent with the findings of a previous study (This study has some limitations. First, esketamine is contraindicated in patients with severe hypertension and abnormal thyroid function; therefore, the population selected for this study did not include mothers with complicated pregnancies. Second, we did not measure esketamine levels in breast milk, and although studies have reported that low-dose esketamine has no effect on breastmilk or newborns, it is possible to monitor esketamine levels in breast milk in subsequent studies. None of the newborns in this study had any adverse outcomes.