Trial reportFrontiers in pharmacology2026
Effects of hydromorphone for patient-controlled intravenous analgesia on postpartum depression and sleep disorders after cesarean section: a randomized, double-blind controlled trial.
Trial report in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Background: Postpartum depression (PPD) is a significant concern in obstetrics. This study aimed to investigate the effects of hydromorphone in patient-controlled intravenous analgesia (PCIA) on PPD and sleep disorders following cesarean section. Methods: A total of 140 parturients undergoing elective cesarean section under combined spinal-epidural anesthesia, with singleton full-term pregnancy and aged 22-35 years, were enrolled from July to December 2025 at Jiangning Hospital Affiliated to Nanjing Medical University. Using a random number table, participants were allocated to two groups based on PCIA formulation: the sufentanil group (Group S) received sufentanil (3 μg/kg) + tropisetron (0.1 mg/kg) diluted to 150 mL with normal saline; the hydromorphone group (Group H) received hydromorphone (0.15 mg/kg) + tropisetron (0.1 mg/kg) diluted to 150 mL with normal saline. The primary outcome was the incidence of PPD at 6 weeks postoperatively. Secondary outcomes included PPD incidence at 1 week, Ramsay sedation scores at 24 and 48 h, Pittsburgh Sleep Quality Index (PSQI) scores preoperatively and at 24/48 h, resting Visual Analog Scale (VAS) pain scores at 6, 12, 24, and 48 h, PCIA button presses and rescue analgesia within 48 h, cumulative 48-hour opioid consumption, bowel function recovery time, first lactation time, neonatal behavioral neurological assessment (NBNA) scores at 48 h postoperatively and adverse reactions. Results: The incidence of PPD at 6 weeks was significantly lower in Group H compared to Group S [5.8% vs. 20.6%, relative risk (RR) = 0.28, 95% confidence interval (CI) 0.10 to 0.78, Conclusion: Hydromorphone for PCIA after cesarean section can reduce the incidence of PPD at 6 weeks, improve early postoperative sleep quality, and decrease dizziness and drowsiness. Clinical Trial Registration: https://www.chictr.org.cn/bin/home, identifier ChiCTR2500105264.
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