Analgesia outcomes, obstetric outcomes and side effects
| Esketamine 0 mg ml−1 (n=30) | Esketamine 0.2 mg ml−1 (n=30) | Esketamine 0.3 mg ml−1 (n=30) | Esketamine 0.4 mg ml−1 (n=30) | Esketamine 0.5 mg ml−1 (n=30) | p value | |
| Sensory level at 30 min after the epidural injection | T10 (T8, T10) | T9 (T6, T10) | T10 (T8, T10) | T10 (T8, T10) | T9 (T8, T10) | 0.971 |
| Bromage score at 30 min after the epidural injection | 0 | 0 | 0 | 0 | 0 | – |
| Ropivacaine consumption (mg h−1) | 12.0 (9.5, 13.9) | 10.5 (7.9, 12.5) | 9.5 (7.4, 11.0)* | 9.4 (7.1, 11.3)* | 9.0 (7.1, 11.0)* | 0.002 |
| Number of parturients with effective analgesia | 16 | 17 | 17 | 18 | 18 | 0.995 |
| Number of parturients with ineffective analgesia | 14 | 13 | 13 | 12 | 12 | 0.995 |
| Analgesia success rate (%) | 53.3 | 56.7 | 56.7 | 60.0 | 60.0 | |
| Pain visual analogue scale score at 30 min after the epidural injection (0–100 mm) | 10 (7, 45) | 8 (3, 45) | 9 (7, 41) | 9 (7, 39) | 9.0 (8, 38) | 0.880 |
| Satisfaction with labour/childbirth at 1 hour after delivery (%) | 98 (87, 100) | 98 (86, 100) | 98 (89, 100) | 96 (89, 99) | 97 (86, 100) | 0.960 |
| Labour duration (min) | ||||||
| First stage | 560 (407, 751) | 450 (294, 556) | 420 (243, 867) | 419 (280, 611) | 510 (364, 690) | 0.077 |
| Second stage | 54 (33, 92) | 51 (31, 102) | 64 (47, 121) | 41 (30, 57) | 59 (37, 104) | 0.157 |
| Caesarean delivery (n, %) | 5 (16.7) | 2 (6.7) | 3 (10.0) | 2 (6.7) | 2 (6.7) | 0.728 |
| Hypotension (n, %) | 1 (3.3) | 0 (0.0) | 1 (3.3) | 0 (0.0) | 3 (10.0) | 0.274 |
| Ramsay score | 2 (2, 2) | 2 (2, 2) | 2 (2, 2) | 2 (2, 2) | 2 (2, 2)*†‡§ | <0.001 |
| Desaturation¶ (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Numbness or pain in the limb (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Dizziness (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 3 (10.0) | 4 (13.3)*†‡ | 0.013 |
| Vertigo (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Hallucination (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Diplopia (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Nightmare (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Nystagmus (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Irritability (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Headache (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Vertigo (n, %) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
| Fetal bradycardia (n, %) | 1 (3.3) | 1 (3.3) | 1 (3.3) | 1 (3.3) | 1 (3.3) | >0.999 |
| Umbilical artery PH | 7.34±0.07 | 7.35±0.10 | 7.32±0.04 | 7.33±0.04 | 7.36±0.09 | 0.306 |
| Apgar score at 1 min | 10 (10, 10) | 10 (10, 10) | 10 (10, 10) | 10 (10, 10) | 10 (10, 10) | 0.462 |
| Apgar score at 5 min | 10 (10, 10) | 10 (10, 10) | 10 (10, 10) | 10 (10, 10) | 10 (10, 10) | >0.999 |
Data are presented as number (%), mean±SD or median (IQR).
*p<0.005, compared with esketamine 0 mg⋅mL−1 after Bonferroni correction.
†p<0.005, compared with esketamine 0.2 mg⋅mL−1 after Bonferroni correction.
‡p<0.005, compared with esketamine 0.3 mg⋅mL−1 after Bonferroni correction.
§p<0.005, compared with esketamine 0.4 mg⋅mL−1 after Bonferroni correction.
¶Desaturation was defined as oxygen saturation below 90%.