Use of Various Doses of S-Ketamine in Treatment of Depression and Pain in Cervical Carcinoma Patients with Mild/Moderate Depression After Laparoscopic Total Hysterectomy
Jie Wang, Yajun Wang, Xudong Xu, Sheng Peng, Feng Xu, Peirong Liu
Medical Science Monitor April 27, 2020 DOI: 10.12659/msm.922028 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 417 |
| Population | Cervical carcinoma patients with mild/moderate depression undergoing laparoscopic modified radical hysterectomy |
| Interventions | S-ketamine racemic ketamine |
| Dose | 0.5 mg/kg, 0.25 mg/kg |
| Topics | Depression Esketamine Ketamine |
| Citations | 80 |
| Key findings | High-dose S-ketamine (0.5 mg/kg) improved short-term depression and pain more than low-dose S-ketamine, racemic ketamine, or control, but benefits disappeared by one week after surgery. |
Abstract
Background: This study investigated the effects of various doses of S-ketamine on depression and pain management of cervical carcinoma patients with mild/moderate depression. Material/Methods This randomized, double-blind, controlled study included 417 cervical carcinoma patients who received laparoscopic modified radical hysterectomy from April 2015 to July 2018 and who also had mild/moderate depression symptoms based on HAMD-17 scores (8~24). All patients were randomized into 4 groups: 1) the control group, 2) the racemic ketamine group, 3) the high-dose S-ketamine group; and 4) the low-dose S-ketamine group. Pain was assessed using the Visual Analogue Score (VAS), and depression was assessed using theHAMD-17 score. Serum levels of BDNF and 5-HT were measured.
Results: The 4 groups of patients showed no significant differences in operation time, bleeding volume, hospitalization duration, or complications. The high-dose S-ketamine group showed significantly lower VAS and HAMD-17 scores than all other groups at 1 day and 3 days postoperatively, but no differences were observed in the low-dose S-ketamine group and the racemic ketamine group. The high-dose S-ketamine group showed significantly higher serum BDNF and 5-HT levels at 1 day and 3 days after surgery. However, 1 week after surgery, no difference was observed in any of the treatment groups.
Conclusions: At subanesthetic dose, both 0.5 mg/kg and 0.25 mg/kg S-ketamine improved short-term depression and pain for cervical carcinoma patients after surgery, and the effects were better than with the same dose of racemic ketamine.