Effect of ropivacaine-dexamethasone combination on postpartum uterine pain, inflammation, and breastfeeding in multiparous women

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OBJECTIVE: To investigate the effects of epidural ropivacaine combined with dexamethasone on postpartum uterine cramping pain, inflammatory markers, and breastfeeding behavior in multiparous women. METHODS: This retrospective cohort study included 336 women who underwent vaginal delivery and received postpartum epidural analgesia between May 2022 and November 2024, including 211 multiparous women. The observation group (n = 172) received 0.15% ropivacaine combined with 10 mg dexamethasone, while the control group (n = 164) received only 0.15% ropivacaine. The severity of uterine cramping pain was assessed using the Visual Analogue Scale (VAS) at 2, 6, 12, 24, and 48 hours postpartum. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured using ELISA, and C-reactive protein (CRP) was measured using a quantitative laboratory assay, at 6, 24, and 72 hours postpartum. Breastfeeding indicators and adverse events were recorded. RESULTS: The VAS scores at all time points in the observation group were significantly lower than those of the control group (all P < 0.001), with a lower rescue analgesia rate (10.47% vs. 21.34%, P = 0.006). At 24 hours postpartum, the observation group showed significantly lower levels of TNF-α, IL-6, and CRP, and significantly higher levels of IL-10 (all P < 0.001); shorter first breastfeeding time (38.00 minutes vs. 52.00 minutes, P < 0.001); higher frequency of breastfeeding within 48 hours postpartum; and a higher rate of exclusive breastfeeding on day 7 postpartum (84.30% vs. 68.29%, P < 0.001). There were no significant differences in adverse events or neonatal outcome between the two groups (both P > 0.05). CONCLUSIONS: Epidural analgesia with ropivacaine combined with dexamethasone effectively alleviates postpartum uterine cramping pain in multiparous women, regulates the inflammatory responses, improves breastfeeding outcomes, and has a good safety profile.

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