Effect of pre-administration of esketamine intraoperatively on postpartum depression after cesarean section: A randomized, double-blinded controlled trial.
Wei Wang, Bin Ling, Qian Chen, Hua Xu, Jie Lv, Wanyou Yu
Medicine March 1, 2023 DOI: 10.1097/md.0000000000033086 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 120 |
| Population | Women aged 24 to 36 years undergoing cesarean section under spinal-epidural anesthesia with American Society of Anesthesiologists physical status II |
| Interventions | Esketamine normal saline |
| Dose | 0.2 mg/kg |
| Duration | Follow-up at 1 week and 6 weeks after surgery; adverse effects assessed at 48 hours |
| Topics | Ketamine Depression Esketamine |
| Keywords | Humans Depression, postpartum Anesthesia, epidural Cesarean section Pregnancy Infant Female |
| Key findings | Intravenous esketamine 0.2 mg/kg given after infant delivery during cesarean section significantly reduced the incidence of postpartum depression at 1 week and 6 weeks after surgery compared with saline, without a significant difference in adverse effects at 48 hours. |
Abstract
Background: To evaluate the effect of pre-administration of esketamine intraoperatively on the occurrence of postpartum depression after cesarean section under combined spinal-epidural anesthesia.
Methods: A total of 120 women aged 24 to 36 years undergoing cesarean section by spinal-epidural anesthesia with American Society of Anesthesiologists physical status II were enrolled. According to the intraoperative use of esketamine, all participants were randomly divided into 2 groups: test group (group E) and control group (group C). Esketamine was administered intravenously at a dose of 0.2 mg/kg after the infant was delivered in group E and equal volume of normal saline was given in group C. The incidence of postpartum depression was recorded at 1 week and 6 weeks after the operation. The occurrence of adverse reactions such as postpartum bleeding, nausea and vomiting, drowsiness, and nightmares were also recorded at 48 hours after surgery.
Results: Compared with group C, the incidence of postpartum depression was significantly lower at 1 week and 6 weeks after surgery in group E (P < .01). There was no significant difference of the adverse effects at 48 hours after the operation between the 2 groups.
Conclusion: Intravenous infusion of 0.2 mg/kg esketamine in women during cesarean section can significantly reduce the incidence of postpartum depression at 1 week and 6 weeks after surgery without increasing related adverse effects.
Comparable studies
Other randomized controlled trials on esketamine for depression, most cited first.