Effect of esmketamine for labor analgesia on development of postpartum depression
10.3760/cma.j.cn131073.20230211.01114
- VernacularTitle:艾司氯胺酮用于硬膜外分娩镇痛对产后抑郁症发生的影响
- Author:
Jianxin GAO
1
;
Qin ZHOU
;
Dan MIAO
;
Lan DAI
;
Dan PENG
;
Baiqing DUAN
;
Liping LI
Author Information
1. 湖南师范大学附属长沙市妇幼保健院麻醉科，长沙 410007
- Keywords:
Cyclohexanes;
Analgesia, obstetrical;
Analgesia, epidural;
Natural childbirth;
Depression, postpartum
- From:
Chinese Journal of Anesthesiology
2023;43(11):1351-1354
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of esmketamine for labor analgesia on the occurrence of postpartum depression (PPD).Methods:Two hundred and forty-two cases of nulliparous parturients who selected natural labor and agreed to receive labor analgesia were selected and divided into conventional labor analgesia group (C-LA group, n=119) and esmketamine-based labor analgesia group (E-LA group, n=123). The epidural labor analgesia solution contained ropivacaine 100 mg and sufentanil 30 μg in 100 ml of normal saline in C-LA group. The epidural labor analgesia solution contained ropivacaine 100 mg, sufentanil 30 μg and esketamine 50 mg in 100 ml of normal saline in E-LA group. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen parturients for depression on admission to the predelivery room and at 2 h and 1, 7 and 42 days after delivery, and EPDS scores were recorded. The patients were diagnosed as having PPD when EPDS score ≥ 9 at 7-42 days after delivery. Peripheral venous blood samples were collected on admission to the predelivery room and at 1 day after delivery to determine the concentrations of serum estrogen, progesterone, 5-hydroxytryptamine and cortisol by enzyme linked inmunosorbent assay. Results:Compared with group C-LA, the EPDS scores were significantly decreased on the 1 and 42 days after delivery( P<0.01), no significant change was found in the incidence of PPD (1.7%/0.8%, P>0.05), no significant change was found in the concentrations of serum estrogen, progesterone, 5-hydroxytryptamine and cortisol on admission to the delivery room ( P>0.05), and the concentrations of serum progesterone and cortisol were significantly increased on 1 day after delivery in group E-LA ( P<0.05). Conclusions:Combination of esketamine is helpful in reducing the risk of postpartum depression when used for epidural labor analgesia, and the mechanism is related to slowing the declines in blood levels of sex hormones and stress hormones after delivery.
