Efficacy of a single low dose of esketamine after childbirth for mothers with symptoms of prenatal depression: randomised clinical trial

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e078218 - e078218

Published: April 10, 2024

Abstract Objective To determine whether a single low dose of esketamine administered after childbirth reduces postpartum depression in mothers with prenatal depression. Design Randomised, double blind, placebo controlled trial two parallel arms. Setting Five tertiary care hospitals China, 19 June 2020 to 3 August 2022. Participants 364 aged ≥18 years who had at least mild as indicated by Edinburgh postnatal scale scores ≥10 (range 0-30, higher indicating worse depression) and were admitted hospital for delivery. Interventions randomly assigned 1:1 receive either 0.2 mg/kg or infused intravenously over 40 minutes once the umbilical cord been clamped. Main outcome measures The primary was prevalence major depressive episode 42 days post partum, diagnosed using mini-international neuropsychiatric interview. Secondary outcomes included score seven partum 17 item Hamilton rating 0-52, depression). Adverse events monitored until 24 hours childbirth. Results A total (mean age 31.8 (standard deviation 4.1) years) enrolled randomised. At observed 6.7% (12/180) participants group compared 25.4% (46/181) (relative risk 0.26, 95% confidence interval (CI) 0.14 0.48; P<0.001). lower (median difference −3, CI −4 −2; P<0.001) (−3, also (−4, −6 −3; overall incidence adverse (45.1% (82/182) v 22.0% (40/182); P<0.001); however, symptoms lasted less than day none required drug treatment. Conclusions For depression, decreases episodes about three quarters. Neuropsychiatric more frequent but transient did not require intervention. Trial registration ClinicalTrials.gov NCT04414943 .

Language: Английский

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Effects of ketamine and esketamine on preventing postpartum depression after cesarean delivery: A meta-analysis

Journal of Affective Disorders, Journal Year: 2024, Volume and Issue: 351, P. 720 - 728

Published: Jan. 28, 2024

Ketamine and esketamine has been suggested to have potential efficacy in preventing postpartum depression (PPD) recent years. The aim of this meta-analysis was evaluate the effectiveness ketamine on PPD after cesarean delivery.

Language: Английский

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Perioperative Adjunctive Esketamine for Postpartum Depression Among Women Undergoing Elective Cesarean Delivery

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(3), P. e240953 - e240953

Published: March 6, 2024

Importance Postpartum depression (PPD) is one of the most common mental health conditions during perinatal and postpartum periods, which can have adverse effects on both mother infant. Objective To investigate efficacy perioperative adjunctive esketamine administration after cesarean deliveries in prevention PPD. Design, Setting, Participants A single-center, double-blind, placebo-controlled, randomized clinical trial was conducted from January 1, 2022, to 2023, at Fujian Provincial Hospital among 298 women aged 18 40 years, with an American Society Anesthesiologists grade I III classification singleton full-term pregnancies who were scheduled for elective deliveries. Primary analyses performed a modified intention-to-treat basis. Interventions Patients randomly assigned (n = 148) control 150) groups. Those group received single intravenous injection 0.25 mg/kg immediately fetal delivery, followed by 50 mg as adjuvant patient-controlled analgesia 48 hours surgery. Saline given patients. Main Outcomes Measures The primary outcome assessments PPD symptoms using Edinburgh Postnatal Depression Scale (EPDS) day 7. Positive screening defined score 10 or more points EPDS. In addition, EPDS analyzed continuous variable evaluate depressive symptoms. Secondary outcomes included Numeric Rating (NRS) postoperative pain, along safety evaluations including events days 14, 28, 42. Results total pregnant included, 150 (median age, 31.0 years [IQR, 29.0-34.0 years]) 148 28.0-34.0 years]). prevalence significantly lower patients compared controls (23.0% [34 148] vs 35.3% [53 150]; odds ratio, 0.55; 95% CI, 0.33-0.91; P .02) also showed change scores (difference least-squares means [SE], −1.17 [0.44]; −2.04 −0.31; effect size, 0.74; .008). However, there no differences between groups incidence positive results changes baseline There NRS rest movement except 72 postoperatively, when (median, 3.0 2.0-3.0] 3.0-3.5]; median difference, 0 [95% 0-0]; .03). Conclusions Relevance These suggest that period delivery improve early period. this antidepression may not be universally applicable low scores. Trial Registration Chinese Clinical Registry Identifier: ChiCTR2100054199

Language: Английский

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Efficacy and safety of perioperative application of esketamine on postpartum depression: A meta-analysis of randomized controlled studies

Psychiatry Research, Journal Year: 2024, Volume and Issue: 333, P. 115765 - 115765

Published: Feb. 2, 2024

Language: Английский

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Association between esketamine interventions and postpartum depression and analgesia following cesarean delivery: a systematic review and meta-analysis

American Journal of Obstetrics & Gynecology MFM, Journal Year: 2024, Volume and Issue: 6(3), P. 101241 - 101241

Published: Jan. 21, 2024

Language: Английский

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Effects of epidural esketamine versus sufentanil on labor analgesia and postpartum depression: a retrospective cohort study

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 7, 2025

There is a lack of research on epidural esketamine for labor analgesia. The purpose this to compare the efficacy and sufentanil analgesia postpartum depression. A total 187 cephalic full-term parturients with single-fetus vaginal delivery were collected in retrospective study from Jan 2022 2023. Parturients categorized into two groups according anesthetics: group (Group KR, n = 97) patient-controlled 0.3 mg/ml 0.083% ropivacaine 240 ml normal saline Sufentanil SR, 90) µg/ml saline. Visual Analogue Scale, Ramsay Sedation Modified Bromage Score recorded before, 5, 10, 30 min after analgesia, when uterine orifice was fully opened, delivery. Edinburgh Postnatal Depression Scale(EPDS) scores at 3 42 days recorded. maternal infant outcomes occurrence adverse reactions VAS 5,10,30 cervix opened higher Group KR than SR (all P < 0.05). RSS lower Compared significant decreases shown EPDS incidence depression has considerably decreased rates pruritus compared (P other effects showed no difference > neonatal not significantly different between In comparison sufentanil, may exhibit better sedative effect, low pruritus, but limited analgesic effect. It be associated risk Further exploration optimal regimen dosage would necessary.

Language: Английский

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Effect of Esketamine Added to Propofol Sedation on Desaturation and Hypotension in Bidirectional Endoscopy

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(12), P. e2347886 - e2347886

Published: Dec. 20, 2023

Importance Propofol sedation is widely used for endoscopic procedures, but it poses risks of hemodynamic and respiratory depression. The addition esketamine as an adjuvant may reduce propofol requirements associated adverse events. Objective To evaluate the effects low-dose added to propofol-based on desaturation hypotension during same-visit bidirectional endoscopy. Design, Setting, Participants This multicenter, double-blind, placebo-controlled randomized clinical trial assessed patients from 3 teaching hospitals in China who were scheduled endoscopy between February 8 November 30, 2022, randomly assigned receive or normal saline (placebo). Interventions After induction with 0.1 μg/kg sufentanil 0.5 mg/kg propofol, group received 0.15 intravenous esketamine, whereas placebo equivalent volume saline. Sedation was achieved through titration. Main Outcomes Measures primary outcome composite procedures. Secondary outcomes included desaturation, hypotension, requirements, postprocedure pain fatigue, nausea vomiting, dizziness headache, hallucination nightmare, endoscopist satisfaction, patient satisfaction. Results Among 663 initially enrolled patients, 660 completed study (median [IQR] age, 48 [36-57] years; 355 [53.8%] female), 331 329 group. administration compared significantly reduced incidence (8.2% vs 21.0%; difference, −12.8 percentage points; odds ratio [OR], 0.34; 95% CI, 0.21-0.54; P &amp;lt; .001). Additionally, led lower incidences (OR, 0.36; 0.18-0.72; false discovery rate q = .01) 0.33; 0.18-0.60; .001) (difference, −58.9 mg; −65.7 −52.2 .001), without significant other secondary outcomes. Conclusions Relevance In this undergoing endoscopy, resulted approximately 61% reduction accompanied by decreased requirements. These findings support use Trial Registration Chinese Clinical Registry Identifier: ChiCTR2200055938

Language: Английский

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Impaired synaptic plasticity and decreased excitability of hippocampal glutamatergic neurons mediated by BDNF downregulation contribute to cognitive dysfunction in mice induced by repeated neonatal exposure to ketamine

CNS Neuroscience & Therapeutics, Journal Year: 2024, Volume and Issue: 30(2)

Published: Feb. 1, 2024

Abstract Aim Repeated exposure to ketamine during the neonatal period in mice leads cognitive impairments adulthood. These are likely caused by synaptic plasticity and excitability damage. We investigated precise role of brain‐derived neurotrophic factor (BDNF) induced repeated period. Methods evaluated function using Morris water maze test novel object recognition test. Western blotting immunofluorescence were used detect protein levels BDNF. blotting, Golgi‐Cox staining, transmission electron microscopy, long‐term potentiation (LTP) recordings assess hippocampus. The neurons was c‐Fos. In intervention experiment, pAdeno‐CaMKIIα‐BDNF‐mNeuronGreen injected into hippocampal CA1 region increase level enhanced a chemogenetic approach. Results Our findings suggest that repeatedly exposed associated with downregulated BDNF level, damage, decreased glutamatergic region. Furthermore, specific upregulation enhancement can improve impaired mice. Conclusion downregulation mediates leading adulthood following

Language: Английский

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Effect of intraoperative and/or postoperative esketamine administration on preventing postpartum depression: A systematic review and meta-analysis

Psychiatry Research, Journal Year: 2024, Volume and Issue: 335, P. 115890 - 115890

Published: April 2, 2024

Language: Английский

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Efficacy of Intravenous Administration of Esketamine in Preventing and Treating Rebound Pain After Thoracic Paravertebral Nerve Block: A Prospective Randomized, Double-Blind, Placebo-Controlled Trial

Drug Design Development and Therapy, Journal Year: 2024, Volume and Issue: Volume 18, P. 463 - 473

Published: Feb. 1, 2024

Purpose: Investigating the efficacy of intraoperative fractionated intravenous esketamine in prevention rebound pain after cessation thoracic paravertebral nerve blockade.Methods: One hundred and twenty patients who underwent elective thoracoscopic lobectomy were selected for study randomly divided into two groups, group was given 0.5 mg/kg 0.3 at induction anaesthesia 30 minutes before end operation, respectively, control an equal amount saline.The incidence (RP) 7 days surgery postoperative recovery compared between groups.Results: The NRS scores 24 48 hours postoperatively significantly lower than those (P < 0.05).The consumption sufentanil less 0.05).Postoperative groups difference not statistically significant.Conclusion: Intravenous reduces scores, decreases block, opioid consumption.

Language: Английский

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