{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T17:59:01Z","timestamp":1773338341298,"version":"3.50.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Postoperative 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred women were randomly assigned to two groups. The esketamine group received 1\u00a0mg\u22c5kg<jats:sup>-1<\/jats:sup>\u22c5d<jats:sup>-1<\/jats:sup> of esketamine +1\u00a0\u00b5g\u22c5kg<jats:sup>-1<\/jats:sup>\u22c5d<jats:sup>-1<\/jats:sup> of sufentanil for intravenous postoperative analgesia, and the control group received 1\u00a0\u00b5g\u22c5kg<jats:sup>-1<\/jats:sup>\u22c5d<jats:sup>-1<\/jats:sup> of sufentanil for intravenous analgesia. The primary outcome was the pain intensity during the postoperative 24\u00a0h, 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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The VAS scores at rest were lower in the esketamine group than in the control group during the postoperative 6\u00a0h\u201324\u00a0h (<jats:italic>p<\/jats:italic> &amp;lt; 0.05), and the VAS scores at cough in the esketamine group were lower during the postoperative 4\u00a0h\u201324\u00a0h (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). There were significant differences at blood loss during the postoperative 24\u00a0h (137.6 \u00b1 33.0 vs 159.6 \u00b1 41.3 mL, <jats:italic>p<\/jats:italic> = 0.004). Blood pressure and heart rate were greater in the esketamine group than in the control group during the postoperative 8\u00a0h\u201324\u00a0h (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The incidence of nausea and vomiting was significantly lower in the esketamine group than in the control group (4% vs 18%, <jats:italic>p<\/jats:italic> = 0.025).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This 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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.chictr.org.cn<\/jats:ext-link>, Identifier ChiCTR2400082094<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1579633","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T07:23:57Z","timestamp":1744615437000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of esketamine\u2013sufentanil for patient-controlled intravenous analgesia in women following cesarean section: A randomized clinical trial"],"prefix":"10.3389","volume":"16","author":[{"given":"Yanping","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaming","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1213\/ANE.0000000000004729","article-title":"Analgesic effect of intraoperative intravenous S-ketamine in opioid-na\u00efve patients after major lumbar fusion surgery is temporary and not dose-dependent: a randomized, double-blind, placebo-controlled clinical trial","volume":"132","author":"Brinck","year":"2021","journal-title":"Anesth. Analg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"6195","DOI":"10.12998\/wjcc.v12.i28.6195","article-title":"Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section","volume":"12","author":"Chen","year":"","journal-title":"World J. Clin. Cases"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e240953","DOI":"10.1001\/jamanetworkopen.2024.0953","article-title":"Perioperative adjunctive esketamine for postpartum depression among women undergoing elective cesarean delivery: a randomized clinical trial","volume":"7","author":"Chen","year":"","journal-title":"JAMA Netw. 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Devel Ther."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1524198","DOI":"10.1155\/2022\/1524198","article-title":"A study on the preventive effect of esketamine on postpartum depression (PPD) after cesarean section","volume":"2022","author":"Wang","year":"","journal-title":"Comput. Math. Methods Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e32010","DOI":"10.1097\/MD.0000000000032010","article-title":"Effects of esketamine on analgesia and postpartum depression after cesarean section: a randomized, double-blinded controlled trial","volume":"101","author":"Wang","year":"","journal-title":"Med. 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