Clinical Effects of Low-Dose Esketamine During Emergency Conversion From Labor Epidural Analgesia to Category I Cesarean Section: A Randomized Controlled Trial of Maternal Hemodynamics, Analgesia, Sedation, and Neonatal Outcomes

Background: Emergency conversion from labor epidural analgesia to Category I cesarean section leaves little time for epidural top-up to produce a surgical block. We examined whether low-dose intravenous esketamine could provide short-term bridging analgesia and sedation while maintaining maternal hemodynamics, oxygenation, and early neonatal safety. Methods: In this randomized study, parturients requiring Category I cesarean section after labor epidural analgesia received either esketamine 0.15 mg/kg or normal saline 1 min before skin incision, together with epidural alkalinized lidocaine. The

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