The Effect of Anesthesia Method on Melatonin Level and Its Relationship With Postpartum Depression ın Cesarean Section Patients

Abstract

Objective Our study aimed to establish the effects of anesthetic agents used in cesarean sections on melatonin levels and to evaluate the possible association between melatonin levels and postpartum depression. Materials and methods Our study was approved by the Erzincan Binali Yıldırım University Ethics Committee (approval number: 25.07.2017 11/11). We included 231 pregnant women between the ages of 18 and 45 who were admitted for a cesarean section to Erzincan Mengücek Gazi Training and Research Hospital Anesthesiology and Reanimation Clinic. The pregnant women were divided into three groups that underwent general, spinal, and combined spinal-epidural anesthesia, respectively. These approaches were determined by the preference of the attending anesthesiologist. On the postoperative first day at 5:00 am, peripheral venous blood samples were obtained from the subjects for melatonin level measurement. Samples were centrifuged and kept in -80 °C until the testing for melatonin with the enzyme-linked immunosorbent assay (ELISA) method. In order to determine the depression status, the subjects were evaluated with the Edinburgh Postpartum Depression Scale. Results Of all the anesthesia types given to the subjects, 16% was combined spinal-epidural anesthesia, 18.2% was general anesthesia, and 65.8% was spinal anesthesia. According to the scale, 68% of the subjects had no depression and 32% had depression. The depression rate in subjects who underwent general anesthesia was significantly higher than in other groups (p<0.001). The association between the anesthesia method and melatonin levels had no statistically significant difference (p=0.53). The association between depression status and melatonin levels had no statistically significant difference among the two groups (p=0.097). Conclusion We aimed to evaluate the effect of the chosen anesthesia method on postoperative melatonin levels and postpartum depression and found that the chosen method of anesthesia does not affect postoperative melatonin levels significantly but the usage of general anesthesia significantly raises the postpartum depression rate among subjects. We also did not find any correlation between postoperative melatonin levels and postpartum depression.