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CompletedNCT03309163ETPPDUpdated Aug 14, 2019

Effect of Tramadol in Prevention of Postpartum Depression

A Phase 4 interventional study of Tramadol and Hydromorphone in Caesarean Section, sponsored by Xinqiao Hospital of Chongqing. Completed at 1 site in China. Open to female participants aged 20 Years to 40 Years. Per ClinicalTrials.gov, last updated 2019-08-14.

Sponsored by Xinqiao Hospital of Chongqing · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
1,230
Allocation
Randomized
Ages
20 Years to 40 Years
Sex
Female
01

Study summary

The incidence of postpartum depression in Europe and the United States is about 10%, while in China the incidence rate of 15.7-39.8%. Postpartum depression is one of the most common diseases of perinatal distress, but the current research of high-quality prevention and treatment of postpartum depression is still very lack. The study suggests that the risk of postpartum depression in cesarean delivery is significantly higher than that in vaginal delivery. Therefore, postpartum depression in cesarean delivery may require more attention and treatment.Tramadol is a non-opioid central analgesic that relieves common to severe pain, and tramadol has an inhibitory effect on norepinephrine and serotonin systems and has the potential to reduce depression and anxiety. Therefore, for the analgesic demand and antidepressant demand for maternal who undergoing cesarean section, tramadol may be an optimized and effective analgesic for the prevention and treatment of postpartum depression.

Read the detailed description

This study was designed according to a prospective, randomized, controlled clinical trial. Randomized subjects were randomly assigned to different analgesic drug-treated groups according to the random number induced by SPSS software. All three analgesic treatments were routinely used for clinical analgesia; Anesthesia, surgery, postoperative treatment are in accordance with clinical practice. The investigators conducted a postoperative questionnaire survey and psychological diagnosis for all patients. And blood sample was collected from patients before and 48 hours after the surgery.

02

Conditions studied

  • Caesarean Section
03

Who can participate

Ages eligible
20 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • 20 years old ≤ age ≤ 40 years old;
  • ASA score I-Ⅱ;
  • uncomplicated and singleton full-term pregnancy;
  • voluntarily to receive cesarean section and postoperative controlled analgesia;
  • consent to participate the study.

Exclusion criteria

Exclusion Criteria:

  • with history of mental disorders or psychotropic substances use;
  • with history of neurological diseases such as epilepsy
  • with history of previously known diagnosed depression;
  • with suicidal ideation or history of suicide;
  • with history of drug,alcohol or opioid abuse;
  • with monoamine oxidase (MAO) inhibitor treatment at present or in the past 14 days;
  • participating in other clinical studies
  • with severe heart disease, brain disease, liver disease and kidney disease;
  • be allergic to tramadol or opioids;
  • with any contraindication for combined spinal epidural anesthesia;
  • incapable of communication or cooperation.
04

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
1,230 participants (actual)

Study arms

  • Active comparator
    Group T

    All patients receive the patient-controlled intravenous analgesia with Tramadol.

    Drug: Tramadol

  • Placebo comparator
    Group H

    All patients receive the patient-controlled intravenous analgesia with Hydromorphone.

    Drug: Hydromorphone

  • Placebo comparator
    Group E

    All patients receive the patient-controlled epidural analgesia with Ropivacaine.

    Drug: Ropivacaine (Epidural analgesia)

Interventions

  • DrugTramadol

    Patient-controlled intravenous analgesia with Tramadol

  • DrugHydromorphone

    Patient-controlled intravenous analgesia with Hydromorphone

  • DrugRopivacaine (Epidural analgesia)

    Patient-controlled epidural analgesia with Ropivacaine.

05

What researchers measure

Primary outcomes

  1. The incidence of postpartum depression

    Diagnosed according to DSM-5 diagnostic criteria for postnatal depression

    Time frame: At 4 weeks after the surgery

Secondary outcomes

  1. The incidence of postpartum depression

    Diagnosed according to DSM-5 diagnostic criteria for postnatal depression

    Time frame: At 3 months after the surgery

  2. EPDS scores

    Measured using Edinburgh Postnatal Depression Scale

    Time frame: At 4 weeks and 3 months after the surgery

  3. GAD-7 scores

    Measured using Generalized Anxiety Disorder Scale

    Time frame: At 4 weeks and 3 months after the surgery

  4. QoR-15 scores

    Measured using Quality of recovery 15

    Time frame: 48 hours after the surgery

  5. Pain intensity

    Pain VAS at 6, 12, 24 and 48 hours after the surgery

    Time frame: At 6, 12, 24 and 48 hours after the surgery

  6. Norepinephrine and serotonin levels in the blood

    Norepinephrine and serotonin concentration in the blood at 48 hours after the surgery

    Time frame: At 48 hours after the surgery

Other outcomes

  1. Early walking time

    The time for patient to independently activity

    Time frame: During hospitalization, an average of 36 hours

  2. Hospital stays

    The time for patient to stay in hospital after the surgery

    Time frame: During hospitalization, an average of 72 hours

  3. Pain intensity

    Postoperative pain intensity that evaluated by questionnaire at 3 months after the surgery

    Time frame: At 3 months after the surgery

06

Study locations

1 site
  • Xinqiao Hospital, Third Military Medical University
    Chongqing, Chongqing 400037, China
07

References and documents

Publications

  • Wu Z, Zhao P, Peng J, Fang L, Ding J, Yan G, Wang Y, Zhu J, Wang D, Li Y, Chen Z, Zhang Q, Deng Q, Duan G, Zuo Z, Li H. A Patient-Controlled Intravenous Analgesia With Tramadol Ameliorates Postpartum Depression in High-Risk Woman After Cesarean Section: A Randomized Controlled Trial. Front Med (Lausanne). 2021 May 27;8:679159. doi: 10.3389/fmed.2021.679159. eCollection 2021. PubMed 34124111 ↗
  • Duan G, Wu Z, Zhao P, Peng J, Chen Z, Zhang Q, Xu R, Li H. Protocol for a randomised, double-blind, placebo-controlled trial to explore the effect of tramadol in the prevention of postpartum depression (ETPPD). BMJ Open. 2018 Oct 21;8(10):e022538. doi: 10.1136/bmjopen-2018-022538. PubMed 30344172 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT03309163
Lead sponsor
Xinqiao Hospital of Chongqing
Responsible party
Hong Li (Director, Department of Anesthesiology, Xinqiao Hospital of Chongqing) — Principal investigator
First posted
Oct 13, 2017
Start date
Oct 9, 2017
Primary completion
Jun 13, 2019
Completion
Aug 13, 2019
Last update
Aug 14, 2019

Study contacts

Hong Li, M.D.
principal investigator · Department of Anesthesiology, Xinqiao Hospital, Third Military Medical University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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