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Single low-dose esketamine improves postpartum depression symptoms and recovery quality in cesarean section women.

Ran Jing, Yuanyan Tu

American Journal of Translational Research 2026 DOI: 10.62347/euok7911 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 136
Population Women scheduled for elective cesarean section
Interventions Esketamine Patient-controlled intravenous analgesia
Dose 0.2 mg/kg
Topics Esketamine Depression
Keywords Low dose Cesarean section Patient-controlled intravenous analgesia Postpartum depression
Key findings A single low-dose esketamine combined with PCIA significantly lowers early postpartum depression symptoms and improves recovery quality after cesarean section, with no increase in adverse reactions.

Abstract

To investigate the effects of single low-dose esketamine combined with patient-controlled intravenous analgesia (PCIA) on early postpartum depression symptoms and recovery quality in women undergoing cesarean section. This prospective, randomized, controlled study enrolled 136 women scheduled for elective cesarean section, who were randomly assigned in a 1:1 ratio to the study group (esketamine group, n=68) or the control group (placebo group, n=68). In the study group, esketamine (0.2 mg/kg) was intravenously infused for 40 minutes immediately after fetal delivery. In the control group, an equal volume of normal saline was given. Both groups then received PCIA for pain relief maintenance after the operation. The Edinburgh Postnatal Depression Scale (EPDS) scores, Obstetric Quality of Recovery-10 (ObsQoR-10) scores, and postoperative recovery indicators were compared between groups at different time points after surgery. Compared with the control group, the study group showed significantly lower EPDS scores at postoperative days 2 and 7, higher ObsQoR-10 scores, shorter times to first ambulation, flatus, and breastfeeding, as well as increased breastfeeding frequency within 48 hours (all P<0.05). The incidence of adverse reactions revealed no statistically significant difference (P>0.05). A single low-dose esketamine combined with PCIA effectively alleviates early postpartum depression symptoms, enhances postoperative recovery in women undergoing cesarean section, and demonstrates good safety and clinical applicability.

Comparable studies

Other randomized controlled trials on esketamine for depression, 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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