Trial reportActas espanolas de psiquiatria2025
Effects of Esketamine on Post-Partum Depression in Patients With Different Personality Types Undergoing Caesarean Section: Randomised Controlled Trial.
Trial report in Actas espanolas de psiquiatria, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundAs an intravenous general anaesthetic, esketamine has rapid and evident antidepressant effects and therefore helps prevent post-partum depression (PPD). This study aimed to observe the effect of intraoperative esketamine application on patients with PPD undergoing caesarean section and to explore whether this effect varies among patients with different personality types.
methodsA total of 280 patients who underwent elective caesarean section under spinal anaesthesia were randomly divided into esketamine and control groups. On the day before the surgery, each patient was assessed using the Edinburgh Post-partum Depression Scale (EPDS), Self-Rating Anxiety Scale(SAS), Self-Rating Depression Scale (SDS) and Eysenck Personality Questionnaire. Additionally, the pressure-pain threshold was measured. The esketamine group received a single intravenous injection of esketamine at a dose of 0.25 mg/kg (diluted to 5 mL and administered intravenously within 10 min after foetus removal). The control group received 5 mL of 0.9% normal saline. The primary outcome was PPD incidence, assessed using the EPDS on the 3rd post-operative day. The secondary outcomes included post-operative pain score and esketamine safety assessment.
resultsStatistically significant differences in PPD incidence were observed among patients with different personality types (introverted unstable, 66.70%; extroverted unstable, 45.50%; extroverted stable, 19.40%; and introverted stable, 15.00%, p < 0.05). The patients with an extroverted-stable personality in the esketamine group had a lower PPD incidence than those in the control group (11.90% vs. 25.70%, p < 0.05). No statistical difference in total PPD incidence was observed between the two groups (35.7% vs. 29.3%, p > 0.05). Pain scores in the esketamine group were lower than those in the control group while at rest (4, 24 and 48 h) and during movement (4 and 8 h) after surgery (p < 0.05). The mean arterial pressure and heart rate in the esketamine group were higher than those in the control group during surgery (p < 0.05).
conclusionA single intravenous administration of esketamine had no apparent effect on the overall PPD incidence among patients undergoing caesarean section. It may have a beneficial effect in reducing PPD incidence in patients with an extroverted-stable personality.
trial registrationChinese Clinical Trial Registry, ChiCTR2100050976, 09/09/2021, http://www.chictr.org.cn.
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