The effect of low-dose esketamine on maternal depression after cesarean delivery.
Yan Shang, Siyuan Li, Qin Zheng, Tingting Mi, Yuzhu Lv, Lichun Han, Binrong Wang
Journal of psychosomatic obstetrics and gynaecology December 1, 2025 DOI: 10.1080/0167482X.2025.2527659 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Placebo-controlled Double-blind Peer reviewed |
|---|---|
| Sample size | 186 |
| Population | Women aged 20-50 years undergoing cesarean section under epidural anesthesia |
| Intervention | Esketamine |
| Dose | 0.25 mg/kg |
| Topics | Esketamine Depression |
| Keywords | Epds Cesarean section Patient-controlled intravenous analgesia Postpartum depression Enhance maternal well-being Promising approach |
| Citations | 8 |
| Key findings | Low-dose intravenous esketamine significantly reduced EPDS scores at 5, 7, and 14 days post-cesarean section compared to placebo. |
Abstract
To assess the impact of low-dose intravenous esketamine on postpartum depression scores in women undergoing cesarean section. In a randomized, double-blind, placebo-controlled trial, 186 women aged 20-50 years receiving epidural anesthesia for cesarean section were divided into three groups: Group A (0.25 mg/kg esketamine intraoperatively + esketamine in PCIA), Group B (0.25 mg/kg esketamine intraoperatively + PCIA without esketamine), and Group C (placebo intraoperatively + PCIA without esketamine). The primary outcome was the change in Edinburgh Postnatal Depression Scale (EPDS) scores. Secondary outcomes included Pittsburgh Sleep Quality Index (PSQI) scores, Visual Analogue Scale (VAS) scores, PCIA bolus frequency, and adverse events. EPDS and PSQI scores decreased significantly post-surgery across all groups (p < 0.05). Groups A and B showed greater EPDS score reductions than Group C at 5, 7 and 14 days postoperatively (p < 0.01). No significant differences were observed in PSQI scores, VAS scores or PCIA bolus frequency between groups. Adverse events though mild and transient, were more frequent in Group A (p < 0.01). Low-dose intravenous esketamine, reduces postpartum depression scores post-cesarean section, with a safe profile despite increased mild adverse events when combined with PCIA.
Comparable studies
Other randomized controlled trials on esketamine for depression, most cited first.