Effects Of Intraoperative Dexmedetomidine Infusion On Postpartum Depression In Women Undergoing Cesarean Delivery

ObjectiveTo observe and analyze the effect of prophylactic use of dexmedetomidine on the occurrence of postpartum depression in women undergoing cesarean delivery.To investigate whether dexmedetomidine has a preventive effect on postpartum depression and to discuss its possible related mechanisms.MethodsSixty patients who were to undergo low lower uterine segment cesarean section in our hospital were selected based on inclusion and exclusion criteria.The patients were divided into 2 groups by random number table method: control group(Group C)and dexmedetomidine group(Group D),30 cases in each group.Preoperatively,basic prenatal information was collected and the Hospital Anxiety and Depression Score(HADS)was performed.During the operation,when the fetus was delivered and the umbilical cord was severed,dexmedetomidine 0.5ug/kg was immediately pumped intravenously in group D and the pumping was completed in 10 minutes.In group C,the same amount of saline was pumped with the same protocol.Intraoperative observations were recorded at room entry(T0),at successful anesthesia(T1),5 min after successful anesthesia(T2),at umbilical cord severance(T3),5 min after umbilical cord severance(T4),10 min after umbilical cord severance(T5),at suture skin(T6),and at the end of surgery(T7)for heart rate(HR),oxygen saturation(Sp O2),and mean arterial pressure(MAP),and at the end of surgery(T7)for Ramsay Sedation score.The occurrence of adverse reactions such as nausea and vomiting,sinus bradycardia during the operation was recorded.The occurrence of adverse reactions such as Numerical Rating Scale(NRS),nausea and vomiting at 1 day postoperative(T8)was recorded in the postoperative follow-up.EPDS score and breastfeeding at 7 days postoperatively(T9)and EPDS score at42 days postoperatively(T10).Results1.There was no statistical difference in the general information of patients in both groups(P>0.05),and all patients were free of domestic violence.2.Incidence of PPD: The incidence of PPD in group D was lower than that in group C at 7 days postpartum,and was statistically significant(P<0.05).The incidence of PPD in group D was lower than that in group C at 42 days postpartum,but the difference was not statistically significant(P>0.05).3.EPDS score: The EPDS score of patients in group D was lower than that in group C at 7 days postpartum,and it was statistically different(P<0.05).There was no statistical difference in EPDS scores between the two groups at 42 days postpartum(P>0.05).4.Risk factors for PPD: High HADS score was a risk factor for the occurrence of PPD at 7 days postpartum and 42 days postpartum.Postpartum breastfeeding was a protective factor for the occurrence of PPD at 42 days postpartum(P<0.05).Conclusion1.Intraoperative dexmedetomidine infusion during cesarean delivery reduces the occurrence of short-term postpartum PPD,decreases postoperative pain scores,and is hemodynamically stable without increasing the risk of excessive sedation.2.High HADS score is a risk factor for the development of PPD,and breastfeeding is a protective factor for PPD.