The incidence of postpartum depression in Europe and the United States is about 10%, while in China the incidence rate of 15.7-39.8%. Postpartum depression is one of the most common diseases of perinatal distress, but the current research of high-quality prevention and treatment of postpartum depression is still very lack. The study suggests that the risk of postpartum depression in cesarean delivery is significantly higher than that in vaginal delivery. Therefore, postpartum depression in cesarean delivery may require more attention and treatment.Tramadol is a non-opioid central analgesic that relieves common to severe pain, and tramadol has an inhibitory effect on norepinephrine and serotonin systems and has the potential to reduce depression and anxiety. Therefore, for the analgesic demand and antidepressant demand for maternal who undergoing cesarean section, tramadol may be an optimized and effective analgesic for the prevention and treatment of postpartum depression.
This study was designed according to a prospective, randomized, controlled clinical trial. Randomized subjects were randomly assigned to different analgesic drug-treated groups according to the random number induced by SPSS software. All three analgesic treatments were routinely used for clinical analgesia; Anesthesia, surgery, postoperative treatment are in accordance with clinical practice. The investigators conducted a postoperative questionnaire survey and psychological diagnosis for all patients. And blood sample was collected from patients before and 48 hours after the surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
1,230
Patient-controlled intravenous analgesia with Tramadol
Patient-controlled intravenous analgesia with Hydromorphone
Patient-controlled epidural analgesia with Ropivacaine.
Xinqiao Hospital, Third Military Medical University
Chongqing, Chongqing Municipality, China
The incidence of postpartum depression
Diagnosed according to DSM-5 diagnostic criteria for postnatal depression
Time frame: At 4 weeks after the surgery
The incidence of postpartum depression
Diagnosed according to DSM-5 diagnostic criteria for postnatal depression
Time frame: At 3 months after the surgery
EPDS scores
Measured using Edinburgh Postnatal Depression Scale
Time frame: At 4 weeks and 3 months after the surgery
GAD-7 scores
Measured using Generalized Anxiety Disorder Scale
Time frame: At 4 weeks and 3 months after the surgery
QoR-15 scores
Measured using Quality of recovery 15
Time frame: 48 hours after the surgery
Pain intensity
Pain VAS at 6, 12, 24 and 48 hours after the surgery
Time frame: At 6, 12, 24 and 48 hours after the surgery
Norepinephrine and serotonin levels in the blood
Norepinephrine and serotonin concentration in the blood at 48 hours after the surgery
Time frame: At 48 hours after the surgery
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