Evidence map›Paper›PMID 39556562›Full record

SynthesisPloS one2024

Perioperative administration of sub-anesthetic ketamine/esketamine for preventing postpartum depression symptoms: A trial sequential meta-analysis.

Kuo-Chuan Hung, Chia-Li Kao, Yi-Chen Lai, Jen-Yin Chen, Chien-Hung Lin, Ching-Chung Ko, Chien-Ming Lin, I-Wen Chen

Abstract readMeta-Analysis
In one paragraph

Synthesis in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kuo-Chuan HungDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Chia-Li KaoDepartment of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Yi-Chen LaiDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Jen-Yin ChenDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Chien-Hung LinDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Ching-Chung KoDepartment of Medical Imaging, Chi Mei Medical Center, Tainan City, Taiwan.
Chien-Ming LinDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
I-Wen ChenDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.ORCID 0009-0004-7122-6901

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePostpartum 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.

methodsRandomized controlled trials (RCTs) comparing ketamine/esketamine to a placebo for PPD prevention were searched without language restriction. Primary outcomes were PPD risk at 1- and 4-6-week postpartum. Secondary outcomes included the difference in depression scores and risk of adverse events. Trial sequential analysis (TSA) was conducted to validate the reliability.

resultsA meta-analysis of 22 RCTs (n = 3,463) showed that ketamine/esketamine significantly decreased PPD risk at 1- (risk ratio [RR], 0.41; 95% confidence interval [CI], 0.3-0.57) and 4-6-week (RR, 0.47; 95%CI, 0.35-0.63) follow-ups. Consistently, participants receiving ketamine/esketamine had lower depression-related scores at 1- (standardized mean difference [SMD], -0.94; 95%CI, -1.26 to -0.62) and 4-6-week (SMD, -0.89; 95%CI, -1.25 to -0.53) follow-ups. Despite potential publication bias, TSA confirmed the evidence's reliability. Subgroup analysis showed that ketamine/esketamine's preventive effect on 1-week PPD was consistent, regardless of administration timing, type of agents, or total dosage (<0.5 vs. ≥0.5 mg/kg). For the 4-6-week period, PPD risk was favorably reduced only with postoperative administration or the use of esketamine, with the total dosage having no observed influence. Participants on ketamine/esketamine experienced more frequency of hallucinations (RR, 4.77; 95%CI, 1.39-16.44) and dizziness (RR, 1.36; 95%CI, 1.02-1.81).

conclusionOur findings advocate for the postoperative administration of low-dose ketamine/esketamine to avert PPD, which needed additional research for confirmation.

Indexed as

Depression, PostpartumKetamineFemaleHumansPerioperative CareRandomized Controlled Trials as TopicEsketamineKetamine

Identifiers

PMID39556562
PMCPMC11573214

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.