Department of Anesthesiology, School of Paramedical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Department of Reproductive Health and Midwifery, School of Nursing and Midwifery; Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
J Med Life. 2021 Jan-Mar;14(1):87-92. doi: 10.25122/jml-2020-0116.
Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was conducted to evaluate the effect of ketamine on preventing postpartum depression in women undergoing caesarian sections considering the relatively known positive effect of ketamine on major depression. The present double-blind, randomized clinical trial was conducted on 134 women undergoing scheduled caesarian sections. Participants were randomly allocated into two groups of control and intervention. To induce anesthesia, 1-2 mg/kg of body weight of Nesdonal and 0.5 mg/kg of body weight of ketamine were used in the intervention group, while only 3-5 mg/kg of body weight Nesdonal was administered in the control group. Data were gathered using the Edinburgh Postnatal Depression Scale (EPDS) in three stages: before the caesarian section and two and four weeks after the caesarian section. Data were analyzed using variance analysis with repeated measures and the Chi-square test. Results of the present study showed that the mean (± standard deviation) of the depression score in the intervention and control groups were 13.78±3.87 and 13.79±4.78(p = 0.98) before the caesarian section, 11.82±3.41 and 14.34±4.29 (p < 0.001) two weeks after and 10.84±3.48 and 13.09±3.79 (p = 0.001) four weeks after the caesarian section, respectively. Using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression. However, further studies are required to strengthen these findings.
产后抑郁症是一种常见的致残性心理社会障碍，可对母婴和家庭生活产生不良影响。本研究旨在评估氯胺酮预防剖宫产妇女产后抑郁症的效果，考虑到氯胺酮对重度抑郁症的相对已知的积极作用。本双盲、随机临床试验纳入了 134 例行择期剖宫产的妇女。参与者被随机分为对照组和干预组。干预组使用 1-2mg/kg 体重的 Nesdonal 和 0.5mg/kg 体重的氯胺酮诱导麻醉，而对照组仅给予 3-5mg/kg 体重的 Nesdonal。使用爱丁堡产后抑郁量表（EPDS）在三个阶段收集数据：剖宫产前、剖宫产后 2 周和 4 周。使用重复测量方差分析和卡方检验进行数据分析。本研究结果显示，干预组和对照组的抑郁评分均值（±标准差）分别为剖宫产前 13.78±3.87 和 13.79±4.78（p=0.98），剖宫产后 2 周 11.82±3.41 和 14.34±4.29（p<0.001），剖宫产后 4 周 10.84±3.48 和 13.09±3.79（p=0.001）。在全身麻醉诱导中使用氯胺酮可能有效预防产后抑郁症。然而，需要进一步的研究来加强这些发现。
