After cesarean section, intravenous esketamine added to standard pain control reduced maximum pain scores within the first 24 hours (median 5 vs. 6 on a 0-10 scale) and also lessened pain at rest, with movement, and visceral pain at all measured time points. Women receiving esketamine had lower rates of postoperative depression, anxiety, and sleep disorders, as well as lower levels of the inflammatory marker C-reactive protein. The time before the first patient-controlled painkiller press was longer in the esketamine group. No significant differences were seen in hyperalgesia or side effects between groups.
Median nerve stimulation combined with high gamma band activity can map the hand motor cortex during awake states, but its effectiveness declines with loss of consciousness. In five patients undergoing awake craniotomy, the sensitivity of mapping using the short-latency average envelope remained relatively stable, dropping only from 100% awake to about 82% during deeper anesthesia stages. In contrast, mapping based on average power deteriorated more sharply, from 100% awake to around 21% at the deepest stage. The long-latency average envelope also showed reduced sensitivity as consciousness declined, with a slope coefficient significantly smaller than that for short-latency responses. These results suggest that short-latency envelope-based mapping is more robust across different conscious states.