Effect of transcutaneous electrical acupoint stimulation on sleep quality after cesarean section and postpartum depression in parturients with sleep disorders / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the sleep quality after cesarean section and postpartum depression in parturients with sleep disorder.Methods:A total of 225 parturients, aged 20-45 yr, weighing 50-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cesarean section, were enrolled in this study.The Pittsburgh Sleep Quality Index (PSQI) scale was used to investigate the sleep quality before operation.PSQI score<7 was defined as having no sleep disorder, and the patients were included in the non-sleep disorder group (NSD group, n=76). PSQI score≥7 was defined as having sleep disorder, and the patients were randomly divided into sleep disorder group (SD group, n=73) and TEAS group ( n=76). Routine combined spinal-epidural anesthesia was performed in NSD group and SD group.In TEAS group, Neiguan, Baihui, Zusanli and Sanyinjiao acupoints were selected for performing TEAS from the completion of combined spinal-epidural anesthesia to the end of operation, and TEAS was performed for 30 min on the 1st and 2nd days after operation.Patient-controlled intravenous analgesia was applied after operation in the three groups.The blood samples were taken from the cubital vein before operation and at 1 and 2 days after operation for determination of the plasma melatonin and prolactin concentrations (by enzyme-linked immunosorbent assay). The Leeds Sleep Evaluation Questionnaire (LSEQ) was used to evaluate the quality of sleep before operation and at 1, 2 and 7 days after operation.The Edinburgh Postpartum Depression Scale was used to evaluate the postpartum depression at 6 weeks after operation. Results:Compared with NSD group, LSEQ scores were significantly decreased at each time point after operation, the incidence of postpartum depression was increased, and the concentrations of plasma melatonin and prolactin were decreased, and the lactation initiation time was prolonged in SD group ( P<0.05). Compared with SD group, LSEQ scores were significantly increased at each time point after operation, the incidence of postpartum depression was decreased, and the concentrations of plasma melatonin and prolactin were increased, and the lactation initiation time was shortened in TEAS group ( P<0.05). Conclusion:TEAS can raise the the sleep quality after cesarean section and reduce the occurrence of postpartum depression in the parturients with sleep disorders.