Yang Xu1, Yuantao Li2, Xiaolei Huang1, Daili Chen1, Baozuan She1, Daqing Ma3. 1. Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China. 2. Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China. sylyt6788@sina.com. 3. Section of Anaesthetics, Pain Medicine & Intensive Care, Department of Surgery & Cancer, Faculty of Medicine, Chelsea & Westminster Hospital, Imperial College London, 369 Fulham Road, London, UK.
Abstract
PURPOSE:Postpartum depression is a common complication of childbirth. In the last decade, it has been suggested that subdissociative-dose ketamine is a fast-acting antidepressant. We aimed to investigate the efficacy of low-dose ketamine administered during caesarean section in preventing postpartum depression. METHODS: Using a randomized, double-blind, placebo-controlled design, 330 parturients who were scheduled to undergo caesarean section were enrolled in this trial. The parturients were randomly assigned to receive intravenous ketamine (0.25 mg/kg diluted to 10 mL with 0.9% saline) or placebo (10 mL of 0.9% saline) within 5 min following clamping of the neonatal umbilical cord. The primary outcome was the degree of depression, which was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) (a threshold of 9/10 was used) at 3 days and 6 weeks after delivery. The secondary outcome was the numeric rating scale score of pain at 3 day and 6 week postpartum. RESULTS: No significant differences were found in the prevalence of postpartum depression between the two groups at 3 days and 6 weeks after delivery. The pain scores measured at 3 days postoperatively were not significantly different between the groups, whereas the scores measured at 6 week postpartum were significantly reduced in the treatment group compared with the saline group (P = 0.014). CONCLUSIONS: Intra-operative low-dose ketamine (0.25 mg/kg) does not have a preventive effect on postpartum depression.
RCT Entities:
PURPOSE:Postpartum depression is a common complication of childbirth. In the last decade, it has been suggested that subdissociative-dose ketamine is a fast-acting antidepressant. We aimed to investigate the efficacy of low-dose ketamine administered during caesarean section in preventing postpartum depression. METHODS: Using a randomized, double-blind, placebo-controlled design, 330 parturients who were scheduled to undergo caesarean section were enrolled in this trial. The parturients were randomly assigned to receive intravenous ketamine (0.25 mg/kg diluted to 10 mL with 0.9% saline) or placebo (10 mL of 0.9% saline) within 5 min following clamping of the neonatal umbilical cord. The primary outcome was the degree of depression, which was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) (a threshold of 9/10 was used) at 3 days and 6 weeks after delivery. The secondary outcome was the numeric rating scale score of pain at 3 day and 6 week postpartum. RESULTS: No significant differences were found in the prevalence of postpartum depression between the two groups at 3 days and 6 weeks after delivery. The pain scores measured at 3 days postoperatively were not significantly different between the groups, whereas the scores measured at 6 week postpartum were significantly reduced in the treatment group compared with the saline group (P = 0.014). CONCLUSIONS: Intra-operative low-dose ketamine (0.25 mg/kg) does not have a preventive effect on postpartum depression.
Entities:
Keywords:
Caesarean section; Depression; Ketamine; Pain; Postpartum; Prevention and control
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