Evidence map›Paper›PMID 39170110›Full record

ArticleHeliyon2024

Exploring the Analgesic Efficacy and mechanisms of low-dose esketamine in pregnant women undergoing cesarean section: A randomized controlled trial.

Junhua Zhang, Dina Sun, Jing Wang, Jie Chen, Yuanjing Chen, Bin Shu, He Huang, Guangyou Duan

Registry-linked trialAbstract read
In one paragraph

Article in Heliyon, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05414006 (Effect of S-ketamine in Cesarean Section Combined Anesthesia), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05414006 phase4completednot on this map

Effect of S-ketamine in Cesarean Section Combined Anesthesia

TypeinterventionalSponsorThe Second Affiliated Hospital of Chongqing Medical UniversityRan2022 to 2022Enrolled120ConditionsPostoperative PainArmsS-ketamine
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Junhua ZhangDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Dina SunDepartment of Gynecology and Obstetrics, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Jing WangDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Jie ChenDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Yuanjing ChenDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Bin ShuDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
He HuangDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Guangyou DuanDepartment of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Postoperative pain is a prevalent concern following a cesarean section. This study aimed to investigate the effect and mechanism of low-dose (0.1 mg/kg) esketamine on postoperative pain management in pregnant women undergoing cesarean sections, specifically in cases where both patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) were employed. Methods: Pregnant women intending to undergo elective cesarean section were divided into four subgroups based on the intravenous administration of esketamine and the specific analgesia methods employed: E1 (0.1 mg/kg esketamine + PCEA), E2 (0.1 mg/kg esketamine + PCIA), C1 (saline + PCEA), and C2 (saline + PCIA). The primary outcome was the maximum pain score within 24 h postoperatively. Secondary outcomes included the pressure pain threshold and tolerance at 30 min and 24 h postoperatively, along with the inflammation and adverse event index scores. Results: A total of 118 pregnant women were assigned to the four groups: E1 (n = 29), E2 (n = 29), C1 (n = 30), and C2 (n = 30). Compared with those in the control groups (C1 + C2), the maximum postoperative pain scores within 24 h in the esketamine groups (E1 + E2) were significantly lower (4 [2-5] vs. 4 [4-6], P = 0.002), and the E1 group exhibited superior analgesic effects compared with other groups. No significant differences were observed in postoperative hyperalgesia or inflammation across the four groups. Notably, esketamine combined with PCIA increased the incidence of postoperative nausea and vomiting (7 [25 %] vs. 0 [0 %]; P = 0.005). Conclusion: The administration of low-dose (0.1 mg/kg) esketamine effectively alleviates pain following cesarean section, and the analgesic effect is notably enhanced in combination with PCEA. Importantly, these effects do not appear to be mediated through anti-inflammatory mechanisms or the inhibition of hyperalgesia. Clinical trial registration number: NCT05414006.

Indexed as

Cesarean sectionEsketamineHyperalgesiaInflammation

Identifiers

PMID39170110
PMCPMC11336589

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.