Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail
Abstract Background Postpartum depression (PPD) is a common mental disease in postpartum women, which has received more and more attention in society. Ketamine has been confirmed for its rapid antidepressant effect in women with PPD. We speculate that esketamine, an enantiomer of ketamine, pretreatm...
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| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02398-1 |
| _version_ | 1797355596155977728 |
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| author | Shixia Xu Jiaojiao Yang Jing Li Min Zhang Jie Sun Qingren Liu Jianjun Yang |
| author_facet | Shixia Xu Jiaojiao Yang Jing Li Min Zhang Jie Sun Qingren Liu Jianjun Yang |
| author_sort | Shixia Xu |
| collection | DOAJ |
| description | Abstract Background Postpartum depression (PPD) is a common mental disease in postpartum women, which has received more and more attention in society. Ketamine has been confirmed for its rapid antidepressant effect in women with PPD. We speculate that esketamine, an enantiomer of ketamine, pretreatment during cesarean can also reduce the incidence of PPD. Methods All the parturients enrolled in the study were randomly assigned to two groups: the esktamine group (0.2 mg/kg esketamine) and the control group (a same volume of saline). All the drugs were pumped for 40 min started from the beginning of the surgery. The Amsterdam Anxiety and Information Scale (APAIS) scores before the surgery, the Edinburgh postnatal depression scale (EPDS) scores at 4 d and 42 d after surgery, the Pain Numerical Rating Scale (NRS) scores at 6 h, 12 h, 24 h and 48 h post-operation were evaluated, as well as the adverse reactions were recorded. Results A total of 319 parturients were analyzed in the study. The incidence of PPD (EPDS score > 9) in the esketamine group was lower than the control group at 4 days after surgery (13.8% vs 23.1%, P = 0.0430) but not 42 days after surgery (P = 0.0987). Esketamine 0.2 mg/kg could reduce the NRS score at 6 h,12 h and 24 h after surgery, as well as the use of vasoactive drugs during surgery (P < 0.05). The incidences of maternal dizziness (17.0%), blurred vision (5%), illusion (3.8%) and drowsiness (3.8%) in the esketamine group were higher than those of control group (P < 0.05). Conclusions Intraoperative injection of esketamine (0.2 mg/kg) prevented the occurrence of depression (EPDS score > 9) at 4 days after delivery but not 42 days. Esketamine reduced the NRS scores at 6 h, 12 h and 24 h after surgery, but the occurrence of maternal side effects such as dizziness, blurred vision, drowsiness and hallucination were increased. Trial registration Registered in the Chinese Clinical Trial Registry (ChiCTR2100053422) on 20/11/2021. |
| first_indexed | 2024-03-08T14:13:24Z |
| format | Article |
| id | doaj.art-ab2dd51d4e0c42b5a298702acd4a17e2 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-08T14:13:24Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-ab2dd51d4e0c42b5a298702acd4a17e22024-01-14T12:34:05ZengBMCBMC Anesthesiology1471-22532024-01-0124111010.1186/s12871-023-02398-1Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trailShixia Xu0Jiaojiao Yang1Jing Li2Min Zhang3Jie Sun4Qingren Liu5Jianjun Yang6Department of Anesthesiology, Nanjing Medical UniversityDepartment of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityDepartment of Anesthesiology, Xishan People’s Hospital of Wuxi CityDepartment of Anesthesiology, Nanjing Medical UniversityAbstract Background Postpartum depression (PPD) is a common mental disease in postpartum women, which has received more and more attention in society. Ketamine has been confirmed for its rapid antidepressant effect in women with PPD. We speculate that esketamine, an enantiomer of ketamine, pretreatment during cesarean can also reduce the incidence of PPD. Methods All the parturients enrolled in the study were randomly assigned to two groups: the esktamine group (0.2 mg/kg esketamine) and the control group (a same volume of saline). All the drugs were pumped for 40 min started from the beginning of the surgery. The Amsterdam Anxiety and Information Scale (APAIS) scores before the surgery, the Edinburgh postnatal depression scale (EPDS) scores at 4 d and 42 d after surgery, the Pain Numerical Rating Scale (NRS) scores at 6 h, 12 h, 24 h and 48 h post-operation were evaluated, as well as the adverse reactions were recorded. Results A total of 319 parturients were analyzed in the study. The incidence of PPD (EPDS score > 9) in the esketamine group was lower than the control group at 4 days after surgery (13.8% vs 23.1%, P = 0.0430) but not 42 days after surgery (P = 0.0987). Esketamine 0.2 mg/kg could reduce the NRS score at 6 h,12 h and 24 h after surgery, as well as the use of vasoactive drugs during surgery (P < 0.05). The incidences of maternal dizziness (17.0%), blurred vision (5%), illusion (3.8%) and drowsiness (3.8%) in the esketamine group were higher than those of control group (P < 0.05). Conclusions Intraoperative injection of esketamine (0.2 mg/kg) prevented the occurrence of depression (EPDS score > 9) at 4 days after delivery but not 42 days. Esketamine reduced the NRS scores at 6 h, 12 h and 24 h after surgery, but the occurrence of maternal side effects such as dizziness, blurred vision, drowsiness and hallucination were increased. Trial registration Registered in the Chinese Clinical Trial Registry (ChiCTR2100053422) on 20/11/2021.https://doi.org/10.1186/s12871-023-02398-1Cesarean sectionPostpartum depressionEsketamineParturient |
| spellingShingle | Shixia Xu Jiaojiao Yang Jing Li Min Zhang Jie Sun Qingren Liu Jianjun Yang Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail BMC Anesthesiology Cesarean section Postpartum depression Esketamine Parturient |
| title | Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail |
| title_full | Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail |
| title_fullStr | Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail |
| title_full_unstemmed | Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail |
| title_short | Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail |
| title_sort | esketamine pretreatment during cesarean section reduced the incidence of postpartum depression a randomized controlled trail |
| topic | Cesarean section Postpartum depression Esketamine Parturient |
| url | https://doi.org/10.1186/s12871-023-02398-1 |
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