Evaluation of clinical effects of Esketamine on depression in patients with missed miscarriage: A randomized, controlled, double-blind trial.
Ming Jiang, Qianqian Li, Mingjie Mao, Chenyang Xu, Rongrong Zhou, Yazhou Wen, Hongmei Yuan, Shanwu Feng
Journal of Affective Disorders February 28, 2023 DOI: 10.1016/j.jad.2023.02.127 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 105 |
| Population | Patients with missed miscarriages undergoing painless curettage, with preoperative EPDS score of 10 or higher |
| Interventions | Esketamine Propofol Dezocine |
| Duration | Follow-up at 7 and 42 days after the operation |
| Measures | Edinburgh Postnatal Depression Scale (EPDS), VAS |
| Topics | Depression Esketamine Ketamine |
| Keywords | Humans Abortion, spontaneous Propofol Double-blind method Pregnancy Female Missed miscarriage |
| Key findings | Esketamine reduced postoperative depression scores compared with propofol and dezocine at 7 days (6.34 vs. 8.63 and 9.17) and 42 days (5.31 vs. 9.40 and 8.49) after curettage in women with missed miscarriage. Esketamine and dezocine also lowered propofol consumption and 1-hour pain scores, and esketamine was associated with lower postoperative inflammatory markers. |
Abstract
Background: Patients with missed miscarriages are usually accompanied by varying degrees of depression, which is closely related to the patient's prognosis. We investigated whether Esketamine could alleviate postoperative depression symptoms in patients with missed miscarriages who underwent painless curettage.
Methods: This study was a randomized, parallel-controlled, double-blind, single-center trial. A total of 105 patients with preoperative 1d (EPDS) ≥ 10 were randomly assigned to the Propofol; Dezocine; Esketamine group. Patients record EPDS at 7 and 42 days after the operation. Secondary outcomes included VAS for 1 h postoperation, total propofol usage, adverse reactions, And the expressions of inflammatory factors of TNF-α, IL-1β, IL-6, IL-8, and IL-10.
Results: Compared with the P and D group, patients in the S group had lower EPDS scores at 7 day (8.63 ± 3.14, 9.17 ± 3.23 vs. 6.34 ± 2.87 P = 0.0005) and 42 days (9.40 ± 2.67, 8.49 ± 3.05 vs.5.31 ± 2.49 P < 0.0001) after the operation. Respectively, Compared with the P group, the VAS scores (3.51 ± 1.12 vs. 2.80 ± 0.83, 2.40 ± 0.81, P = 0.0035) and the dosage of propofol used during operation (198.7 ± 47.48 vs. 145.5 ± 19.31, 142.9 ± 21.01 P < 0.0001) were lower in the D and S groups, and lower postoperative inflammatory response at 1 day after surgery. Other outcomes among the three groups were not found to the difference.
Conclusions: Esketamine effectively treated postoperative depressive symptoms of patients with a missed miscarriage, decreasing propofol consumption and inflammatory response.
Comparable studies
Other randomized controlled trials on esketamine for depression, most cited first.