Dexmedetomidine Alleviates Postpartum Depressive Symptoms following Cesarean Section in Chinese Women: A Randomized Placebo‐Controlled Study

Yu, He-Ya; Wang, Sai-Ying; Quan, Chengxuan; Fang, Chao; Luo, Shi-Chao; Li, Danyang; Zhen, Shan-Shan; Ma, Jiahui; Duan, Kai-Ming

doi:10.1002/phar.2320

Cited by 34 publications

(32 citation statements)

References 49 publications

(92 reference statements)

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“…Compared with the study done by Yu et al 16 , in the present study, although the HADS scores and anxiety subscale scores on day 2 postpartum were better in the DEX group than in the standard care group, there was a lack of difference in the overall comparison of repeated measurement data between the two groups. On the one hand, this may be because the sample size of this study was calculated based on the primary outcome, so the sample size may have been relatively insufficient to compare the difference in HADS between groups.…”

Section: Discussioncontrasting

confidence: 96%

“…The dose and intervention of DEX we chose was similar to those used in previous research. 16,30 Dexmedetomidine can be safely used in adults, and the dose used in this study is completely acceptable. 31 There was no significant difference between the DEX group and the standard care group in drugrelated adverse events (such as severe bradycardia or fluctuation in blood pressure), which is in agreement with other reports.…”

Section: Discussionmentioning

confidence: 93%

“…13,14 There are also studies reporting the effect of DEX on improving mood. 15,16 Furthermore, it is worth mentioning that DEX can act on the locus coeruleus and thus produce a sedative effect similar to natural sleep by activating endogenous sleep pathways. 17,18 This effect may be helpful for parturient women to avoid various perioperative stresses and improve perioperative comfort without the risk of respiratory depression.…”

Section: Introductionmentioning

confidence: 99%

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<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Wang

Fang

Liu

et al. 2020

DDDT

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Objective: Few studies have investigated the effects of dexmedetomidine (DEX) on breastfeeding after cesarean delivery. A randomized double-blind controlled trial was conducted to investigate whether the administration of DEX, immediately after delivery and for patient-controlled intravenous analgesia (PCIA), can be beneficial for breastfeeding. Patients and Methods: One hundred sixty parturients scheduled for elective cesarean section under spinal anesthesia were randomly allocated to the DEX group (a loading dose of DEX was pumped at 0.5 μg/kg within 10 min, followed by a further infusion of DEX at 0.5 μg/kg/h until the end of the surgery and PCIA for 2 days with DEX plus sufentanil) or the standard care group (infusion saline intraoperatively, and PCIA for 2 days with sufentanil). The number of days required to switch to exclusive breastfeeding within six weeks of delivery, the time to first lactation and breast milk volume on day 1 and day 2 after delivery were recorded. Recovery quality, comfort, anxiety, depression, postoperative analgesia, and adverse reactions of parturients were also assessed. Results: Compared with the standard care group, parturients in the DEX group could be converted to exclusive breastfeeding earlier (11 [14] vs 8 [10] days, log-rank P=0.025), the first lactation time was sooner (28.38 [13.82] vs 33.79 [14.85] hrs, P=0.024), and the amount of breast milk on the second day after delivery increased (P=0.012). There was no difference between the two groups in postpartum uterine contraction pain, but postpartum rest and movement VAS scores and recovery quality score in the DEX group were better than those in the standard care group (all P<0.05). Moreover, the hospital anxiety and depression scale and anxiety subscale score on the second day after delivery and the comfort score on the third day after delivery in the DEX group were significantly better than those in the standard care group (5 [5] vs 6 [8], 2 [2] vs 3 [3], 83.58 [6.75] vs 80.48 [6.58]; P=0.013, P=0.005, P=0.006, respectively). The incidence of adverse events, such as bradycardia, vomiting, hypersomnia, hypertension and hypotension, was not significantly different between the DEX and standard care groups (6.9% vs 2.7%, 5.6% vs 13.7%, 4.2% vs 0%, 5.6% vs 2. 7%, 11.1% vs 8.2%; P=0.275, P=0.158, P=0.366, P=0.681, P=0.556, respectively), except more parturients experienced nausea in the standard care group than in the DEX group (28.8% vs 11.1%, P=0.012). Furthermore, there was no difference in Neonatal Behavioral Neurological Assessment scores on the first and second days after delivery between the DEX and standard care groups (38 [3] vs 37 [2], 38.5 [2] vs 38 [2]; P=0.173, P=0.312, respectively). Conclusion: The application of DEX in the perioperative period of cesarean section was not only conducive to the early conversion of infant feeding to exclusive breastfeeding but could also improve the recovery quality and comfort of the parturient, optimize analgesia, shorten the time to first lactation, and increase lactation.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Wang

Fang

Liu

et al. 2020

DDDT

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“…Yu conducted a randomized interventional study, containing 600 Chinese women, who were listed for cesarean section, while being under spinal anesthesia. The intervention group which received DEX infusion 0.5ug.kg-1 after delivery and PCIA with DEX plus sufentani, compared to the control group, had significantly lower postpartum depression symptoms, as well as better pain scores and sleep quality (33).…”

Section: Hormonal Treatment Options In Postpartum Disordersmentioning

confidence: 95%

Neuroendocrine Aspects of Pregnancy and Postpartum Depression

2019

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Introduction. Ties between the endocrine system and mental health are undeniably a consistent point of interest in modern day medicine. Furthermore, mental disturbances due to hormonal changes following childbirth have been mentioned in medical literature since Hippocrates. Considering the dramatic endocrine, paracrine and autocrine changes that occur during gestation, labour and postnatal phase, hormonal theories are not to be ignored in the treatment of postpartum disorders. Results. Reproductive hormones are known to modulate behavioural, emotional and cognitive response, therefore rapid changes in estradiol and progesterone plasma concentrations during pregnancy and labour create a vulnerable terrain leading towards postpartum disorders. New research shows that women suffering from postpartum disorders have abnormal neural responses, suggesting a neuroendocrine explanation for postpartum syndromes. Conclusion. To facilitate further research in this area, we present new information on several hormonal interactions and the psychiatric response involved in pregnancy and labour, offering an interdisciplinary outlook on pregnancy and postpartum disorders. There is enough evidence to suggest that estradiol, progesterone, oxytocin, cortisol and thyroid hormones are some of many hormones involved in postpartum syndromes and tackling their perinatal imbalance with pharmacological substituents or antagonists could be useful as an adjuvant form of treatment in future patients.

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“…cesarean section, dose finding, hypotension, norepinephrine, spinal anesthesia permitted after a bilateral T6 sensory block. 11 After successful anesthesia, patients were infused with compound sodium chloride (8 ml/ kg/h). Patients received an initial dose of oxytocin (0.5 U; Batch No.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic norepinephrine infusion for postspinal anesthesia hypotension in patients undergoing cesarean section: A randomized, controlled, dose‐finding trial

Chen

Zou

et al. 2021

Pharmacotherapy

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Dexmedetomidine Alleviates Postpartum Depressive Symptoms following Cesarean Section in Chinese Women: A Randomized Placebo‐Controlled Study

Cited by 34 publications

References 49 publications

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Neuroendocrine Aspects of Pregnancy and Postpartum Depression

Prophylactic norepinephrine infusion for postspinal anesthesia hypotension in patients undergoing cesarean section: A randomized, controlled, dose‐finding trial

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