Effect of intravenous esketamine in emergency cesarean deliveries: a retrospective analysis of maternal and neonatal outcomes.
Xiao-Mei Huang, Hong-Xia Qiu
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians December 1, 2024 DOI: 10.1080/14767058.2024.2413855 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective cohort study Peer reviewed |
|---|---|
| Population | Pregnant patients transitioning from labor analgesia to epidural anesthesia for emergency cesarean section |
| Intervention | Esketamine |
| Dose | 0.25 mg/kg |
| Topics | Esketamine |
| Keywords | Emergency cesarean section Neonatal Outcomes Anesthesia anaesthesia Anesthetic Anaesthetic Cesarean delivery c-section Surgical birth Maternal medicine Obstetrics |
| Citations | 3 |
| Key findings | Intravenous esketamine 0.25 mg/kg during emergency cesarean section is correlated with favorable maternal and neonatal outcomes, with maternal blood pressure increases and some transient side effects, but no significant adverse neonatal effects. |
Abstract
This study investigates the effects of administering intravenous esketamine at a dose of 0.25 mg/kg to pregnant patients receiving epidural anesthesia for emergency cesarean section on both maternal and neonatal outcomes. Medical records of pregnant patients transitioning from labor analgesia to epidural anesthesia for emergency cesarean sections between January 2020 and December 2022 were analyzed. The patients were categorized based on whether they received esketamine infusions during the incision-to-delivery interval. The variables compared between the groups included hemodynamic parameters, perioperative and postoperative adverse reactions, and neonatal outcomes (gender, weight, Apgar scores at 1 and 5 min, need for neonatal intensive care, and umbilical artery/vein blood gas analysis). For maternal outcomes, the systolic blood pressure (SBP) in the esketamine group showed a significant increase at 5 and 10 min' post-administration, and the diastolic blood pressure (DBP) significantly increased at 5 min, compared to the control group (p 0.05). The esketamine group experienced a significant rise in the incidence of arrhythmias, dizziness, and nystagmus during the perioperative period, a notable decrease in hypotension incidence, and an increase in postoperative nausea and dizziness. Regarding neonatal outcomes, there were no significant differences in gender, weight, Apgar scores ≤7 at 1 and 5 min, and the need for neonatal intensive care. However, the pH level in the umbilical artery blood of the esketamine group was significantly higher. The levels of PCO2 and PO2 in umbilical artery and venous blood did not show significant differences between the groups. In pregnant women undergoing emergency cesarean section, intravenous administration of 0.25 mg/kg esketamine is correlated with favorable maternal and neonatal outcomes.
Comparable studies
Other observational and cohort studies on esketamine, most cited first.
Citations in the library
Cites 3
- Ketamine and its two enantiomers in anesthesiology and psychiatry: A historical review and future directions Journal of Anesthesia and Translational Medicine July 11, 2024
- Acute Effects of Intravenous Sub-Anesthetic Doses of Ketamine and Intranasal Inhaled Esketamine on Suicidal Ideation: A Systematic Review and Meta-Analysis. Neuropsychiatric Disease and Treatment March 14, 2023
- Antidepressant Efficacy and Tolerability of Ketamine and Esketamine: A Critical Review. CNS Drugs May 2018