The effects of a combination of intravenous dexamethasone and ketamine on postoperative mood in patients undergoing laparoscopically assisted-gynecologic surgery
Cheol Lee, Juhwan Lee, Gilho Lee, Hayeong Lee, Shicheng Zhou, Jihyo Hwang
Psychopharmacology June 14, 2018 DOI: 10.1007/s00213-018-4939-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 297 |
| Population | Patients undergoing gynecologic surgery |
| Interventions | Ketamine Dexamethasone |
| Dose | ketamine 0.5 mg/kg iv; dexamethasone 0.1 mg/kg iv |
| Duration | Assessed on the first and third day after surgery |
| Measures | Patient Health Questionnaire (PHQ)-9, Visual Analog Scale (VAS) for pain, patient controlled analgesia (PCA) consumption |
| Topics | Esketamine Ketamine |
| Key findings | A single dose of ketamine (0.5 mg/kg) with or without dexamethasone significantly reduced PHQ-9 depression scores on postoperative days 1 and 3, whereas dexamethasone alone (0.1 mg/kg) did not change mood scores. The combination of ketamine and dexamethasone also significantly reduced 24-hour pain scores and patient-controlled analgesia consumption compared with either drug alone. |
Abstract
It has been known that anesthetic adjuvants such as dexamethasone or ketamine might change mood. This study aimed to investigate the effects of a single dose of each drug individually along with their combined usage on postoperative mood changes in patients undergoing gynecologic surgery. Two hundred ninety-seven patients randomly allocated were divided into three groups. Group K (n = 99) received a single dose of ketamine (0.5 mg/kg iv); group D (n = 99) received a single dose of dexamethasone (0.1 mg/kg iv), and group KD (n = 99) received both ketamine (0.5 mg/kg iv) and dexamethasone (0.1 mg/kg iv) at 5 min after the induction of anesthesia. A change in the patient health questionnaire (PHQ)-9 scores on the first and third day after surgery, the duration of anesthesia, the postoperative visual analog scale (VAS) for pain, and the patient controlled analgesia (PCA) consumption were evaluated. Groups K and KD showed a significant reduction in PHQ-9 score on both the first and third day after surgery compared with those recorded preoperatively and in group D (P < 0.01). There were no differences in the group D PHQ-9 scores pre- and post-operatively. The VAS for pain 24 h after surgery and the PCA consumption in group KD decreased significantly compared to the other two groups (P < 0.05). A single dose of ketamine (0.5 mg/kg) with or without combination with dexamethasone (0.1 mg/kg) give iv 5 min after induction of general anesthetic produced significant improvement in the postoperative mood scores. A single intravenous dose of dexamethasone (0.1 mg/kg) alone did not change postoperative mood scores. The VAS for pain 24 h after surgery and the PCA consumption was significantly lower in patients who received combination of both drugs.
Comparable studies
Other randomized controlled trials on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Healthy human subjects recruited from the community | 1994 | Randomized controlled trial | n = 19 |
| Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode | 2013 | Randomized controlled trial | n = 73 |
| Remifentanil-induced Postoperative Hyperalgesia and Its Prevention with Small-dose Ketamine Patients undergoing major abdominal surgery | 2005 | Randomized controlled trial | n = 75 |
| Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder Patients with chronic PTSD related to a range of trauma exposures | 2014 | Randomized controlled trial | n = 41 |
| Ketamine-Induced Deficits in Auditory and Visual Context-Dependent Processing in Healthy Volunteers Healthy volunteers | 2000 | Single-blind placebo-controlled study | n = 20 |
Citations in the library
Cited by 5
- Randomized trial of ketamine masked by surgical anesthesia in patients with depression Nature Mental Health October 19, 2023
- Efficacy and safety of perioperative application of ketamine on postoperative depression: A meta-analysis of randomized controlled studies Molecular Psychiatry January 20, 2023
- Randomized Trial of Ketamine Masked by Surgical Anesthesia in Depressed Patients medRxiv Preprint Server April 28, 2023
- The diverse effects of ketamine, jack-of-all-trades: a narrative review. British Journal of Anaesthesia March 1, 2025
- Effects of a single subanesthetic dose of esketamine on postoperative subthreshold depressive symptoms in patients undergoing unilateral modified radical mastectomy: a randomised, controlled, double-blind trial. BMC Psychiatry April 24, 2024
Cites 4
- Ketamine and Rapid-Acting Antidepressants: A Window into a New Neurobiology for Mood Disorder Therapeutics Annual Review of Medicine October 23, 2014
- Ketamine Safety and Tolerability in Clinical Trials for Treatment-Resistant Depression The Journal of Clinical Psychiatry September 2, 2014
- Ketamine as a Fast Acting Antidepressant: Current Knowledge and Open Questions CNS Neuroscience & Therapeutics April 12, 2013
- Investigational drugs in recent clinical trials for treatment-resistant depression Expert Review of Neurotherapeutics January 16, 2017