The Effect Of Intraoperative Dexmedetomidine On Postnatal Depression Score In Primiparas Who Underwent Caesarean Section

Objective:To observe the effect of intraoperative dexmedetomidine(DEX)infusion on the score of Edinburgh postnatal depression scale(EPDS)in primiparas who accepted caesarean section under combined spinal-epidural anesthesia(CSEA).Methods:Forty-two singleton and full-term primiparas,American society of anesthesiologists(ASA)grade Ⅰ or Ⅱ and scheduled for caesarean section under CSEA were enrolled in this study.These primiparas were randomly divided into the DEX group(Group D)and the normal saline group(Group C),with 21 patients in each group.Arriving at the operating room,the forearm superficial vein was punctured as venous access.Electrocardiogram(ECG),pulse oxygen saturation(SpO2),non-invasive blood pressure(NBP)and heart rate(HR)of the primiparas were routinely monitored.In Group D,once the baby was delivered,the loading dose of DEX(0.4μg·kg-1)was infused into the primiparas within 10min through an intravenous infusion pump,and then DEX was continuously infused at a rate of 0.2μg·kg-1·h-1 till the end of the operation.Isovolumic normal saline was infused to primiparas of Group C.The SBP,DBP,HR and SpO2 values were recorded at 5min after entering the operating room(T0),10min after anaesthesia(T1),the delivery time(T2),5min after infusion(T3),15min after infusion(T4)and the end of the operation(T5),respectively.The adverse reactions such as hypotension,hypertension,bradycardia,nausea or vomiting,shivers were observed during the operation.Postpartum depression(PPD)was screened with EPDS 5 days postoperatively.Results:1.The EPDS score of Group D on the 5th day after surgery was significantly lower than that of Group C,with a statistically significant difference(P<0.05).On the 5th day after surgery,the amount of patients with the EPDS score over 8 points in Group D was lower than that in Group C,with a statistically significant difference(P<0.05).2.SBP,DBP,HR of the patients were in the normal range at all time-points,but were lower of Group D than those of Group C at T4 and T5 time-points,and the difference between the two groups was statistically significant(P<0.05).3.The sedation score of Group D was higher than that of Group C,and the difference was statistically significant between the two groups(P<0.05).There was no significant difference between the two groups in the incidence of adverse reactions such as nausea,vomiting and shivers(P>0.05).Conclusions:Dex infusion during caesarean section under CSEA can decrease the EPDS score of the primiparas.