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Efficacy and safety of esketamine for pain control after cesarean delivery: a systematic review and meta-analysis of randomized controlled trials

Tiejia Jiang, Rui Zhao

Frontiers in Pharmacology December 1, 2025 DOI: 10.3389/fphar.2025.1708221 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Population Pregnant women in China
Intervention Esketamine
Topics Ketamine Esketamine
Keywords Randomized controlled trial Anesthesia Pain control Adverse effect Pregnancy Clinical trial Medline
Key findings Esketamine shows favorable efficacy for postoperative analgesia and is associated with a lower risk of postpartum depression, but the result is unstable and may increase dizziness in pregnant women over 30.

Abstract

As a therapy for postoperative analgesia, esketamine shows relatively favorable efficacy in pain control and is associated with a lower risk of postpartum depression. However, this result is unstable. Furthermore, esketamine may increase the risk of dizziness in pregnant women aged over 30 years. Since all the experiments in this study are conducted in China, there are certain regional limitations.

Comparable studies

Other randomized controlled trials on esketamine, most cited first.

Study Year Design Participants
Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study Adults with moderate to severe nonpsychotic depression and a history of nonresponse to... 2019 Phase 3, double-blind, active-controlled, multicenter randomized controlled trial n = 227
Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression Adults with treatment-resistant depression who achieved stable remission or stable... 2019 Phase 3, multicenter, double-blind, randomized withdrawal study n = 297
Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression Adults with DSM-IV-TR diagnosis of major depressive disorder and history of inadequate... 2017 Phase 2, double-blind, doubly randomized, delayed-start, placebo-controlled study n = 67
Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study Depressed patients at imminent risk for suicide 2018 Randomized controlled trial n = 68
Efficacy and Safety of Fixed-Dose Esketamine Nasal Spray Combined With a New Oral Antidepressant in Treatment-Resistant Depression: Results of a Randomized, Double-Blind, Active-Controlled Study (TRANSFORM-1) Adults with moderate-to-severe depression and nonresponse to at least two... 2019 Randomized controlled trial n = 346

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Ketamine Esketamine Depression