Obstetric anesthesia clinic childbirth course combined with labor epidural analgesia is associated with a decreased risk of postpartum depression : a prospective cohort study.

BACKGROUND: Postpartum depression (PPD) is a serious complication commonly seen in postnatal women. In this paper, an investigation was conducted to see if obstetric anesthesia clinic childbirth course combined with labor epidural analgesia (LEA) was associated with a decreased risk of PPD. METHODS: Six hundred fifty-five nulliparous women were enrolled in this prospective cohort study. The parturients were divided into 4 groups, with Group C being the control group, Group AC received the obstetric anesthesia clinic childbirth course only, Group LEA received LEA only, and Group AC + LEA received both the obstetric anesthesia clinic childbirth course and LEA. Maternal and neonatal variables in the perinatal period were recorded. PPD at 6 weeks was assessed using the Chinese version of the Edinburgh Postpartum Depression Scale (EPDS), where a score ≥ 10 is the threshold for PPD. Multivariate logistic regression analysis was performed to assess the association between obstetric anesthesia clinic childbirth course combined with LEA and postpartum depression. RESULTS: A total of 124 maternities had EPDS ≥10 points, the incidence of PPD was 18.9%。The incidence of PPD and EPDS scores were significantly lower in Group AC + LEA than in Group C (12.1% vs 26.8%, P <  0.05; 6 (5, 7) vs 7 (5, 11), P <  0.05). Received an anesthesia clinic childbirth course combined with LEA was associated with a decreased risk of PPD (OR 0.273, 95% CI, 0.100-0.743, P = 0.013). Multivariate logistic regression analysis identified 5 other independent factors for PPD, including maternal SAS score in the delivery room, W-DEQ score in the delivery room, living in a confinement center, EPDS score at 1st week postpartum and perinatal care satisfaction . CONCLUSIONS: Received an obstetrics anesthesia clinic childbirth course combined with LEA for nulliparous women with a single term cephalic pregnancy was associated with a decreased risk of PPD at 6 weeks. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000039163. Registered on 20/10/2020.

Anesthetic Effect of Dexmedetomidine in Clinical Functional Neurosurgery.

Background: Dexmedetomidine is a highly selective and efficient α2-adrenoceptor agonist with good antianxiety, analgesic, hypnotic, and sedative effects without causing respiratory depression. Aim: To investigate the anesthetic effect of dexmedetomidine in clinical neurosurgery. Methods: A total of 94 patients who received functional neurosurgical treatment in our hospital from March 2019 to October 2020 were selected and divided into the study and control groups. Routine anesthesia was adopted in the control group, while dexmedetomidine was used in the study group. Perioperative hemodynamic indicators such as mean arterial pressure, heart rate, and peripheral capillary oxygen saturation, cognitive function score, pain score VAS, stress response index level, and incidence of adverse reactions were compared between the two groups. Results: Before surgery (T0), no significant differences in MAP, HR, and SpO2 were observed between the two groups. However, at the beginning of the operation (T1), 30 min after the operation (T2), and immediately after the operation (T3), these indicators in the study group were significantly higher than in the control group. The postoperative MMSE of the study group 3 d later was significantly higher than that of the control group. The VAS scores after the operation of the study group were lower than those of the control group. The serum cortisol (COR) and aldosterone (ALD) levels in the study group were not significantly different from those in the control group before surgery. The levels of each index in the two groups were higher than those before and 24 h after surgery. The incidence rate of adverse reactions in the study group was lower. Conclusion: The application of dexmedetomidine in clinical functional neurosurgery is safe and can maintain hemodynamic stability and reduce the degree of stress response, cognitive impairment, and pain caused by invasive surgery.