PLoS ONE,
Journal Year:
2024,
Volume and Issue:
19(11), P. e0310751 - e0310751
Published: Nov. 18, 2024
Objective
Postpartum
depression
(PPD)
is
a
major
mental
health
issue
affecting
10%–15%
of
women
globally.
This
meta-analysis
synthesized
updated
evidence
on
sub-anesthetic
ketamine/esketamine’s
efficacy
in
preventing
PPD.
Methods
Randomized
controlled
trials
(RCTs)
comparing
ketamine/esketamine
to
placebo
for
PPD
prevention
were
searched
without
language
restriction.
Primary
outcomes
risk
at
1-
and
4–6-week
postpartum.
Secondary
included
the
difference
scores
adverse
events.
Trial
sequential
analysis
(TSA)
was
conducted
validate
reliability.
Results
A
22
RCTs
(n
=
3,463)
showed
that
significantly
decreased
(risk
ratio
[RR],
0.41;
95%
confidence
interval
[CI],
0.3–0.57)
(RR,
0.47;
95%CI,
0.35–0.63)
follow-ups.
Consistently,
participants
receiving
had
lower
depression-related
(standardized
mean
[SMD],
−0.94;
−1.26
−0.62)
(SMD,
−0.89;
−1.25
−0.53)
Despite
potential
publication
bias,
TSA
confirmed
evidence’s
Subgroup
preventive
effect
1-week
consistent,
regardless
administration
timing,
type
agents,
or
total
dosage
(<0.5
vs.
≥0.5
mg/kg).
For
period,
favorably
reduced
only
with
postoperative
use
esketamine,
having
no
observed
influence.
Participants
experienced
more
frequency
hallucinations
4.77;
1.39–16.44)
dizziness
1.36;
1.02–1.81).
Conclusion
Our
findings
advocate
low-dose
avert
PPD,
which
needed
additional
research
confirmation.
World Journal of Clinical Cases,
Journal Year:
2024,
Volume and Issue:
12(28), P. 6195 - 6203
Published: Aug. 13, 2024
BACKGROUND
Following
cesarean
section,
a
significant
number
of
women
encounter
moderate
to
severe
pain.
Inadequate
management
acute
pain
post-cesarean
section
can
have
far-reaching
implications,
adversely
impacting
maternal
emotional
well-being,
daily
activities,
breastfeeding,
and
neonatal
care.
It
may
also
impede
organ
function
recovery,
leading
escalated
opioid
usage,
heightened
risk
postpartum
depression,
the
development
chronic
postoperative
Both
Chinese
Enhanced
Recovery
After
Surgery
(ERAS)
guidelines
American
ERAS
Society
consistently
advocate
for
adoption
multimodal
analgesia
protocols
in
management.
Esketamine,
functioning
as
an
antagonist
N-Methyl-D-Aspartate
receptor,
has
been
validated
surgical
patients
exhibited
effectiveness
depression
treatment.
Research
suggested
that
incorporating
esketamine
into
via
pumps
lead
improvements
short-term
outcomes.
This
study
aims
assess
efficacy
safety
administering
single
dose
during
section.
AIM
To
investigate
effect
intraoperative
injection
on
rehabilitation
after
METHODS
A
total
315
undergoing
elective
under
combined
spinal-epidural
anesthesia
were
randomized
three
groups:
low-dose
(0.15
mg/kg),
high-dose
(0.25
control
(saline).
Postoperative
Visual
Analog
Scale
(VAS)
scores
recorded
at
6
hours,
12
24
48
hours.
Edinburgh
Postnatal
Depression
(EPDS)
noted
2
days,
7
days
42
days.
Ramsay
sedation
assessed
specified
intervals
post-injection.
adverse
reactions
recorded.
RESULTS
Low-dose
group
compared
group,
had
significantly
lower
VAS
hours
(P
<
0.05),
with
reduced
analgesic
usage
0.05).
EPDS
rates
No
differences
first
exhaust
defecation
times
observed
>
but
ambulation
shorter
higher
5
minutes,
15
upon
room
exit
incidences
hallucination,
lethargy,
diplopia
within
than
CONCLUSION
Esketamine
enhances
recovery;
0.15
mg/kg
is
optimal
sections,
balancing
minimized
effects.
Complementary Medicine Research,
Journal Year:
2025,
Volume and Issue:
unknown, P. 1 - 14
Published: Jan. 21, 2025
Introduction:
Postpartum
depressive
symptoms
(PDS)
are
common
in
women
after
delivery
and
often
progress
to
postpartum
depression
(PPD).
This
secondary
analysis
aimed
evaluate
the
effect
of
acupoint
hot
compress
patients
with
different
PPD
risks.
Methods:
We
conducted
a
data
from
multicenter
randomized
controlled
trial
involving
1085
participants.
Of
these,
537
received
treatment,
while
548
routine
care.
Participants
were
categorized
into
two
groups
based
on
Edinburgh
Postnatal
Depression
Scale
(EPDS)
scores
measured
76.5
hours
delivery.
Baseline
demographic
clinical
characteristics
compared,
logistic
regression
models
used
assess
association
between
PDS.
Subgroup
analyses
determine
participants
Results:
Among
participants,
866
low-risk
group
(EPDS
score
<
9),
219
high-risk
≥
9).
Educational
level,
labor
induction,
uterine
contraction
pain
intensity,
sleep
appetite
during
pregnancy
significantly
impacted
Acupoint
improved
PDS
vaginal
delivery,
particularly
lower
educational
levels,
abnormal
or
sleep,
serve
pain.
Conclusion:
is
an
effective,
non-invasive
intervention
minimal
side
effects
for
improving
symptoms.
BMC Pregnancy and Childbirth,
Journal Year:
2025,
Volume and Issue:
25(1)
Published: Feb. 6, 2025
Abstract
Background
Postpartum
depression
(PPD)
is
categorized
by
the
Disorders-Fifth
Edition
as
that
begins
during
pregnancy
or
within
first
month
after
giving
birth.
Ketamine
and
esketamine
have
shown
promising
results
in
treatment
of
several
depressive
disorders,
which
suggests
they
may
a
role
prevention
PPD.
This
systematic
review
meta-analysis
aim
to
update
evidence
about
efficacy
safety
using
ketamine
reduce
PPD
incidence.
Methods
We
searched
four
databases,
PubMed,
Scopus,
Web
Science,
Cochrane,
collect
relevant
studies.
included
studies
investigated
preventive
effect
on
among
women
birth
through
caesarean
vaginal
delivery.
extracted
occurrence
rate,
score,
pain
score
side
effects.
Finally,
was
conducted
RevMan
software.
Results
Twenty-one
eligible
were
incorporated
current
involving
4,389
pregnant
women.
Esketamine
intervention
14
studies,
used
7
In
subgroup
analysis,
both
significantly
effective
reducing
incidence
short-term
(ketamine:
RR
=
0.72,
95%
CI
[0.56,
0.93],
P
0.01;
esketamine:
0.43,
<
0.0001).
only
reduced
long-term
(RR
0.44,
0.00001).
Low
doses
high
(high
dose:
0.48,
0.0005;
low
0.46,
0.002)
0.54,
0.0001;
0.61,
0.009).
Regarding
risk
effects,
patients
Ketamine/esketamine
group
showed
statistically
significant
higher
rates
developing
dizziness
(
0.0007),
blurred
vision
0.02),
vomiting
0.004)
hallucinations
0,002)
than
control
group.
Conclusion
Both
are
lowering
On
other
hand,
It
recommended
use
smaller
for
more
tolerable
period
since
less
0.5
mg
effective.
Temporary
effects
such
dizziness,
vision,
reported.
Therapeutic Advances in Psychopharmacology,
Journal Year:
2023,
Volume and Issue:
13
Published: Jan. 1, 2023
Background:
In
the
last
few
years,
ketamine
is
becoming
increasingly
common
in
treatment
of
mental
health
conditions,
but
there
a
lack
safety
data
informing
intramuscular
and
sublingual
dosing
community-focused
group
psychotherapy
setting.
The
Roots
To
Thrive
ketamine-assisted
therapy
(RTT-KaT)
program
unique
12-week
RTT-KaT
with
12
community
practice
(a
form
therapy)
sessions
three
medicine
sessions.
Objectives:
This
study
reports
on
adverse
effects
setting
among
128
participants
across
four
cohorts.
Design:
Retrospective
chart
review.
Methods:
A
review
Program
was
performed
retrospectively
cohorts
(
n
=
128)
that
participated
448
running
between
September
2020
December
2021.
Baseline
characteristics
events
were
captured
including
medication
administration
before,
during,
after
Analyses
by
session
individual
conducted.
Chi-square
test
Yates’
continuity
correction
used
to
assess
side
subgroups
from
administration.
Results:
well
tolerated
none
dropping
out
program.
Primarily,
sessions,
49.16%
had
elevated
blood
pressures
post-KaT
session.
terms
other
effects,
12.05%
participant-sessions
experienced
nausea,
2.52%
an
episode
vomiting,
3.35%
headache,
seven
dizziness.
Analysis
revealed
congruent
findings.
Conclusion:
These
findings
suggest
good
tolerability
for
individuals
seeking
issues.
majority
did
not
experience
reactions
recorded
involved
transient
symptoms
resolved
rest
and/or
medications.
model
described
provides
comprehensive
approach
presents
promising
operating
KaT
JAMA Network Open,
Journal Year:
2025,
Volume and Issue:
8(2), P. e2459331 - e2459331
Published: Feb. 13, 2025
Importance
Esketamine
has
been
found
to
reduce
the
incidence
of
postpartum
depression
(PPD)
in
randomized
clinical
trials.
However,
current
evidence
from
trials
does
not
reflect
esketamine’s
efficacy
settings.
Objective
To
assess
intraoperative
esketamine
administration
for
preventing
PPD
among
women
who
underwent
cesarean
delivery.
Design,
Setting,
and
Participants
This
trial
was
conducted
at
The
First
Affiliated
Hospital
Chongqing
Medical
University
Chongqing,
China,
March
2023
February
2024.
Pregnant
patients
admitted
delivery
were
included,
while
those
with
intellectual
dysfunction
or
contraindications
excluded.
All
participants
assigned
randomly
either
group
control
a
1:1
ratio.
Data
analysis
based
on
intention-to-treat
principle.
Interventions
Patients
received
an
infusion
0.25
mg/kg
20
mL
saline
over
minutes,
whereas
minutes.
Main
Outcomes
Measures
primary
outcome
6
weeks
post
partum.
assessed
using
Edinburgh
Postnatal
Depression
Scale.
Results
A
total
308
pregnant
1
2
groups:
(n
=
154;
mean
[SD]
patient
age,
31.57
[4.26]
years)
32.53
[7.74]
years).
Incidence
significantly
lower
compared
partum
(10.4%
[16]
vs
19.5%
[30];
relative
risk,
0.53;
95%
CI,
0.30-0.93;
P
.02).
Conclusions
Relevance
demonstrated
advantage
reducing
safety
warrant
further
investigation
practice.
Trial
Registration
Chinese
Clinical
Registry
Identifier:
ChiCTR2200065494
BMC Surgery,
Journal Year:
2025,
Volume and Issue:
25(1)
Published: April 8, 2025
Postoperative
pain
and
psychological
well-being
in
postpartum
women
following
cesarean
section
are
critical
for
optimal
maternal
recovery.
Traditional
analgesics
often
have
limitations
side
effects,
prompting
the
need
alternative
solutions.
This
study
evaluates
impact
of
an
esketamine
intravenous
analgesic
pump
on
postoperative
status
section.
A
comprehensive
retrospective
evaluation
was
conducted
at
our
institution
from
October
2021
to
July
2023,
including
168
patients
who
underwent
delivery.
The
observation
group
(n
=
82)
received
via
pump,
while
control
86)
traditional
therapy.
Data
collected
included
demographic
information,
surgical
details,
(assessed
using
Visual
Analog
Scale,
VAS),
Edinburgh
Postnatal
Depression
EPDS),
recovery
metrics,
adverse
reactions.
demonstrated
consistently
lower
VAS
scores
all
time
points
compared
group,
indicating
superior
control.
EPDS
were
significantly
3,
5,
14
days
postoperatively,
suggesting
better
outcomes.
incidence
depression
also
days.
Recovery
metrics
such
as
first
ambulation,
flatus,
initiation
lactation
improved
group.
There
no
significant
differences
reactions
between
groups.
use
Esketamine
Intravenous
Analgesic
Pump
reduces
within
It
promotes
early
breastfeeding
without
reactions,
making
it
a
valuable
addition
care.
