A Study on the Preventive Effect of Esketamine on Postpartum Depression (PPD) after Cesarean Section
Qiwei Wang, Maoxin Xiao, Hao Sun, Pengcheng Zhang
Abstract
Objective. The purpose of this study is to explore and analyze the preventive effect of esketamine on postpartum depression (PPD) after cesarean section. Methods. A total of 138 puerperae who underwent cesarean section in our hospital from February 2020 to January 2022 were selected as the research subjects. The control group was given intravenous injection of 2 ml of normal saline after the fetus was delivered. Meanwhile, the observation group was given intravenous injection of a small dose of esketamine (esketamine 0.5 mg/kg+ 2 ml of normal saline) after the delivery of the fetus. The changes of blood pressure and heart rate, the Edinburgh Postnatal Depression Scale (EPDS) questionnaire scores and the incidence of postpartum depression were compared between the two groups. At the same time, the incidence of postoperative adverse events in the two groups was observed. Results. There was no significant difference in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups at T1-T3 ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo>></a:mo> <a:mn>0.05</a:mn> </a:math> ). Compared with the control group, the SBP, DBP, and HR at T4 and T5 in the observation group were higher ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> <c:mo><</c:mo> <c:mn>0.05</c:mn> </c:math> ). There was no significant difference in SBP, DBP, and HR at T3, T4, and T5 in the observation group ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo>></e:mo> <e:mn>0.05</e:mn> </e:math> ). Compared with T3, SBP, DBP, and HR were lower in control group T4 and T5, respectively. There was no significant difference in the EPDS scores between the two groups on the 1st day before delivery ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>P</g:mi> <g:mo>></g:mo> <g:mn>0.05</g:mn> </g:math> ). The EPDS scores of the two groups were higher at 3d postpartum and 42d postpartum, respectively, than at 1d before delivery. The EPDS scores of the observation group at 3d and 42d after delivery were lower than those in the control group ( <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mi>P</i:mi> <i:mo><</i:mo> <i:mn>0.05</i:mn> </i:math> ). Compared with the control group, the incidence of postpartum depression was higher in the observation group at 3 days postpartum and 1 month postpartum, respectively ( <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>P</k:mi> <k:mo><</k:mo> <k:mn>0.05</k:mn> </k:math> ). There was no significant difference in the incidence of postpartum adverse reactions between the two groups ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>P</m:mi> <m:mo>></m:mo> <m:mn>0.05</m:mn> </m:math> ). Conclusion. The application of esketamine after cesarean section can effectively reduce depression-related scores and the risk of postpartum depression without increasing adverse reactions and has high safety.