EXPLORING THE IMPACT OF EPIDURAL LABOR ANALGESIA COMBINED WITH LOW-DOSE ESKETAMINE ON POSTPARTUM DEPRESSION AND ATHLETE RECOVERY

Abstract

Objective: To assess the effectiveness of epidural labor analgesia combined with low-dose esketamine in mitigating postpartum depression among female athletes. Methods: This study involved 240 female athletes who delivered at Longquan Hospital of West China Hospital, Sichuan University, from October 2020 to April 2021. They were randomly divided into four groups: group A (natural birth without medication), group B (epidural labor analgesia, LEA), group C (LEA with low-dose esketamine), and group D (optimized LEA with low-dose esketamine). The primary outcomes measured were postpartum depression rates using the Edinburgh Postnatal Depression Scale (EPDS), pain management effectiveness using the Visual Analogue Scale (VAS), and physiological responses including levels of brain-derived neurotrophic factor (BDNF), 5-hydroxytryptamine (5-HT), and nerve growth factor (NGF). Secondary outcomes included recovery times relevant to athletic performance, such as time to first walk, first bowel movement, and time to lactation initiation. Results: The EPDS and VAS scores indicated significantly lower levels of pain and depression in groups B, C, and D compared to group A, with group D showing the most substantial improvements. Biochemical analysis revealed enhanced levels of BDNF, 5-HT, and NGF in the treatment groups, with the highest concentrations observed in group D. Recovery metrics showed faster return to physical activities in groups B, C, and D, particularly in group D. The incidence of side effects was minimal and comparable across all treatment groups. Conclusion: The combination of epidural labor analgesia and low-dose esketamine is particularly effective in reducing postpartum depression and accelerating postpartum recovery in female athletes. This approach not only ensures better pain management and psychological outcomes but also supports quicker return to training and competitive fitness, highlighting its significant implications for athletic career continuity post-childbirth.