Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study

GUI Qiang-jun; CHEN Xiao-ling; QIN He-jing; CAO Xiang-hua; CAI Mi-li; XU Bin-bin

doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0624

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Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study

Clinical Research | 更新时间：2024-02-19

- Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study
- Journal of Sun Yat-sen University(Medical Sciences) Vol. 44, Issue 6, Pages: 1075-1080(2023)
- 作者机构：
  
  东莞东华医院麻醉科，广东东莞 523000
- 作者简介：
  
  XU Bin-bin； Email： xubinbin075@163.com
- 基金信息：
- DOI：10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0624
  CLC： R713
- Published：20 November 2023，
  
  Received：08 August 2023，
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桂强军,陈晓玲,秦何静等.硬膜外分娩镇痛复合右美托咪定对产妇产后抑郁的影响[J].中山大学学报（医学科学版）,2023,44(06):1075-1080.

GUI Qiang-jun,CHEN Xiao-ling,QIN He-jing,et al.Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(06):1075-1080.
桂强军,陈晓玲,秦何静等.硬膜外分娩镇痛复合右美托咪定对产妇产后抑郁的影响[J].中山大学学报（医学科学版）,2023,44(06):1075-1080. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0624.

GUI Qiang-jun,CHEN Xiao-ling,QIN He-jing,et al.Effects of Epidural Labor Analgesia plus Dexmedetomidine on Postpartum Depression in Parturients： A Prospective Study[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(06):1075-1080. DOI： 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2023.0624.

摘要

目的

观察硬膜外镇痛复合右美托咪定静脉泵注对自然分娩产妇产后抑郁的影响。

方法

选取妇产科自然分娩产妇70例，产妇年龄22~36岁，单胎、头位、足月妊娠，ASA I或Ⅱ级。采用随机数字表法将患者随机分为对照组和实验组各35例，对照组产妇采用罗哌卡因+舒芬太尼实施硬膜外镇痛静脉复合生理盐水泵注（C组），试验组产妇在罗哌卡因+舒芬太尼实施硬膜外分娩镇痛静脉复合右美托咪定泵注（D组）。随访产妇产后1周、6周和12周抑郁程度评分。分别在产后12 h、48 h采集产妇空腹静脉血，测量两组产妇血清催乳素水平；记录两组产妇镇痛前（T1）、镇痛后10 min（T2）、镇痛后30 min（T3）及分娩后12 h（T4）、24 h（T5）五个时间点血流动力学（HR、MAP）水平，VAS评分以及Ramsay评分情况；记录两组产妇镇痛泵按压次数及不良反应情况。

结果

与C组比较，D组产妇产后1周爱丁堡产后抑郁量表（EPDS）评分明显降低；D组产妇产后12 h和48 h催乳素浓度明显升高；T2、T3、T4时VAS评分明显降低，T3时Ramsay评分明显升高，镇痛泵按压次数明显减少（

＜0.05）。

结论

硬膜外镇痛复合右美托咪定静脉泵注可减轻自然分娩产妇产后早期的抑郁程度，促进早期催乳素分泌，同时提供安全有效的辅助镇痛镇静效果。

Abstract

Objective

To investigate the effects of epidural analgesia plus dexmedetomidine infusion on postpartum depression in parturients with natural childbirth.

Methods

We 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.

Results

Compared 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 （

0.05）.

Conclusion

Epidural 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.

关键词

右美托咪定自然分娩分娩镇痛产后抑郁催乳素

Keywords

dexmedetomidinenatural deliverylabor analgesiapostpartum depressionprolactin

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Related Institution

Department of Anesthesiology， The First Affiliated Hospital of Sun Yat-sen University

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1. Department of Anesthesiology

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