Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2023.0624
- VernacularTitle:硬膜外分娩镇痛复合右美托咪定对产妇产后抑郁的影响
- Author:
Qiang-jun GUI
1
;
Xiao-ling CHEN
1
;
He-jing QIN
1
;
Xiang-hua CAO
1
;
Mi-li CAI
1
;
Bin-bin XU
1
Author Information
1. Department of Anesthesiology， Dongguan Tungwah Hospital， Dongguan 523000， China
- Publication Type:Journal Article
- Keywords:
dexmedetomidine;
natural delivery;
labor analgesia;
postpartum depression;
prolactin
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2023;44(6):1075-1080
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the effects of epidural analgesia plus dexmedetomidine infusion on postpartum depression in parturients with natural childbirth. MethodsWe selected 70 parturients aged between 22 and 36， with singleton， term， cephalic presentation， natural delivery and ASA class I or Ⅱ. The cases undergoing epidural analgesia with ropivacaine and sufentanil were randomly divided into two groups by using a random number table （n=35 for each group）. The control group （Group C） used intravenous infusion of normal saline， while the experimental group （Group D） used equivalent volumes of intravenous infusion of dexmedetomidine. Participants were followed up at 1， 6， 12 weeks after childbirth to assess the severity of postpartum depression. Blood samples were collected at 12 h and 48 h after childbirth to measure the serum prolactin levels. The hemodynamic （HR and MAP） changes， VAS scores， and Ramsay scores were recorded at five time points： before analgesia （T1）， 10 min after analgesia （T2）， 30 min after analgesia （T3）， 12 h （T4） and 24 h （T5） after delivery. The number of analgesia pump presses and adverse events were also documented. ResultsCompared with Group C， Group D showed significantly lower EPDS scores at 1 week after childbirth， significantly higher prolactin concentrations at 12 h and 48 h after childbirth， significantly lower VAS scores at T2， T3 and T4， significantly higher Ramsay score at T3 and significantly reduced number of analgesia pump presses （P < 0.05）. ConclusionEpidural analgesia plus intravenous infusion of dexmedetomidine can alleviate early postpartum depression in women undergoing natural delivery， promote early prolactin secretion and provide a safe and effective adjunctive analgesic and sedative effect.
