Pain, depressive symptoms, and sleep disruption frequently overlap during the peripartum period, although their relationships are associative rather than established as causal. Esketamine, an N-methyl-D-aspartate receptor antagonist, has attracted interest as a peripartum intervention with potential effects on pain, mood, and sleep. This narrative review evaluates the clinical and mechanistic...
Purpose: Postoperative anxiety is common in surgical patients and may impair recovery, especially in the patients with preoperative anxiety. However, effective strategies for treating postoperative anxiety remain limited. We hypothesized that esketamine could reduce postoperative anxiety in patients with preoperative anxiety undergoing major abdominal tumor surgery. Patients and Methods: 180...
Abstract Treatment-resistant depression (TRD) is commonly operationalized as non-remission after at least two adequately delivered antidepressant trials, but the biological heterogeneity of this population remains substantial. This article presents a translational hypothesis and drug-development framework; it reports no original clinical or laboratory data and is not a systematic review. The...
Combined low-dose dexmedetomidine and esketamine during cesarean section provides a short-term improvement in early postpartum depressive symptoms, reduces intraoperative neuropsychiatric adverse events, and enhances maternal satisfaction, with a favorable maternal and neonatal safety profile.
Background: This study aimed to estimate the 95% effective dose (ED95) of ciprofol when combined with esketamine or sufentanil in elderly patients undergoing endoscopic submucosal dissection (ESD), and to explore the associated clinical and safety profiles of these sedation strategies. Methods: This study was conducted in two phases. In Phase 1, 44 patients aged 65– 80 years undergoing ESD were...
Depressive disorders remain a major source of disability worldwide, and many patients do not achieve sustained remission despite the availability of multiple antidepressant options. Unmet needs are particularly evident in treatment-resistant depression (TRD) and bipolar depression, where delayed onset of action, incomplete response, relapse, residual functional impairment, and tolerability...
Surgical stress can lead to postoperative anxiety and depression, especially in adolescents. These complications reduce quality of life and increase medical burdens, but perioperative psychological interventions for adolescents are limited, and related mechanisms remain unclear. Esketamine (S-ketamine), an N-methyl-D-aspartate receptor (NMDAR) antagonist, has analgesic, sedative,...
Esketamine is increasingly being applied for preventing postpartum depression (PPD). However, clinical protocols for this application are inconsistent, particularly concerning the route of administration. The aim was to determine whether esketamine bolus administration differed from continuous infusion in terms of preventing PPD. A total of 503 subjects without prenatal depression undergoing...
Postoperative neurocognitive disorder (PND) is a clinically important complication in older surgical patients. Microglial inflammatory activation is frequently accompanied by altered cellular metabolism, but whether esketamine-associated neuroprotection is accompanied by bioenergetic changes in hippocampal CD11b-enriched cell fractions remains incompletely understood. A tibial fracture model...
Background: Comorbid depressive symptoms are prevalent in patients with breast cancer, which adversely impacts postoperative recovery outcomes. Esketamine has emerged as a promising intervention for perioperative depression due to its rapid and sustained effects. This study aims to investigate the impact of the continuous intravenous infusion of esketamine during the perioperative period on...
In elderly patients with preoperative anxiety who undergo gastrointestinal tumor surgery, administering a low-dose intravenous esketamine injection (0.25 mg/kg) during anesthesia induction can decrease the incidence of POD and improve early postoperative cognitive function.
Postoperative sleep disturbance(POSD) is a problem in breast cancer patients after surgery. Little is known about the differences in the treatment of POSD with esketamine combined with dexmedetomidine under the same circumstances. We investigated the effects of intraoperative esketamine combined with intravenous dexmedetomidine on the incidence of POSD and postoperative sleep architecture. A...
Propofol and sufentanil are the most commonly used anesthetics during bronchoscopy. Esketamine is an s-enantiomer of ketamine racemate and has both sedative and analgesic effects, it does not inhibit respiration and maintains hemodynamic stability. We aimed to compare the intraoperative hypoxemia risk of esketamine/propofol with sufentanil/propofol for patients in bronchoscopy. This study was...
This research aimed to quantify the impact of low dose of esketamine on BIS and validate the feasibility of closed-loop TCI system based on the new BIS baseline with low dose of esketamine. This study consisted of two phases. The first phase was to quantify the impact of a low dose of esketamine (0.2mg kg-1 bolus, 5μg kg-1 min-1 infusion for 30min) on BIS and establish a new BIS baseline for...
Analgesics and sedatives may affect the hemodynamics of patients with septic shock and produce adverse reactions. The purpose of this study is to compare the hemodynamic effects and prognosis of esketamine and remifentanil in combination with propofol in patients with septic shock receiving invasive mechanical ventilation. In this single-center, prospective, randomized, controlled pilot study,...
To investigate the efficacy of intranasal esketamine in reducing the incidence of emergence agitation (EA) in pediatric patients undergoing adenotonsillectomy and to determine the optimal dose of esketamine. A total of 204 children aged 3-6 years scheduled for adenotonsillectomy were randomly assigned to three groups. All participants received a standardized anesthetic induction protocol....
We explored whether esketamine anesthesia during first-trimester surgical abortion can reduce intraoperative hemodynamic fluctuations and improve patients' respiratory function. A total of 197 patients who underwent a first-trimester surgical abortion were included in the analysis. Patients were randomly assigned to either the esketamine anesthesia group (group E, n=98) or sufentanil anesthesia...
Postoperative delirium (POD) is a prevalent and severe complication in elderly patients undergoing major surgery, associated with increased morbidity and mortality. This randomized controlled trial aimed to investigate the effects of low-dose esketamine on the incidence of POD in elderly patients underwent total hip or knee arthroplasty. Two hundred and sixty elderly participants were randomly...
Psilocybin, a tryptamine psychedelic, has been touted in the media both historically and recently as a potential game-changing mental health therapeutic. ClinicalTrials.gov has over one hundred and thirty psilocybin clinical trials listed covering the last twenty years. The single most important aspect of any therapeutic is to gain approval for marketing and thus enter the real-world phase of...
The debate continues over the differential impact of remimazolam vs propofol on hemodynamic stability. This study aims to elucidate the effects of a combination of remimazolam and esketamine vs propofol and esketamine on hemodynamic parameters in elderly patients undergoing painless colonoscopies. We conducted a randomized controlled trial involving 754 patients, divided equally between two...
This study aimed to establish the 95% effective dose (ED95) of esketamine in combination with propofol for hysteroscopy and then to evaluate its efficacy and safety profile. This prospective, double-blind, randomized controlled trial consisted of two cohorts. In cohort 1, 45 women aged 18-65 years undergoing hysteroscopy were randomly assigned to either group E (esketamine + propofol) or group...
Emergence delirium and postoperative negative behavioral changes (PNBC) are common complications in pediatric anesthesia. This study evaluated whether intranasal premedication combining dexmedetomidine and esketamine more effectively reduces these complications compared to either drug alone in children undergoing tonsillectomy and/or adenoidectomy with sevoflurane anesthesia. This randomized,...
Propofol injection pain (PIP) is a frequent adverse effect during anesthesia induction, impacting patient comfort and satisfaction. Esketamine has been shown to alleviate PIP, but the optimal dose, especially in relation to preoperative anxiety levels, remains unclear. Preoperative anxiety may heighten pain perception and influence analgesic requirements. A randomized, double-blind, controlled...
Etomidate has been observed to precipitate myoclonus in patients undergoing induction of general anaesthesia. This study was designed to investigate the effect of pretreatment with a small dose of esketamine on the incidence of myoclonus induced by etomidate. One hundred adult patients, who were scheduled to undergo selective operations with general anesthesia, were randomly divided into two...
Purpose: To assess the pharmacokinetics and safety of pure S-ketamine (esketamine) in Chinese patients undergoing painless gastroscopy and evaluate the potential advantage of esketamine in clinical treatment compared with racemate ketamine hydrochloride injection. Patients and methods: A randomized, open-label, parallel-controlled, Phase I study was performed with 32 patients undergoing...