Trial reportBMC anesthesiology2026
Efficacy and safety evaluation of intravenous esketamine in alleviating perioperative depressive symptoms in Parkinson's disease: a randomized controlled trial.
Trial report in BMC anesthesiology, 2026. 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.
Funding
Abstract
objectiveDepressive symptoms frequently afflict individuals with Parkinson’s disease (PD). The current study was consequently conducted to determine the efficacy of low-dose intravenous esketamine in managing postoperative depressive symptoms, thereby exploring its potential mechanisms of action in PD patients subjected to non-intracranial surgery.
methodsIn this randomized, double-blind, placebo-controlled trial, patients were allocated to receive either low-dose esketamine (0.25 mg/kg IV bolus at induction followed by 0.125 mg/kg/h infusion) or placebo. The primary outcome was the Self-Rating Depression Scale (SDS) score assessed preoperatively and on postoperative days 1, 3, and 7. Secondary outcomes included serum levels of 5-HT, norepinephrine (NE), IL-6, and TNF-α, postoperative pain (VAS), and adverse events.
resultsA total of 53 patients were enrolled, including 27 patients (mean age:72.93 ± 6.59, 14 males, mean BMI 22.87 ± 2.71) in the control group (C group), and 26 patients (mean age: 70.46 ± 7.85, 11 males, mean BMI 23.32 ± 3.40) in the esketamine group (ES group). Compared to the control group, ES group showed significantly lower SDS scores at all postoperative time points (p < 0.01), with sustained antidepressant effects through day 7. Esketamine selectively increased 5-HT (p = 0.0005) but not NE levels. It also significantly reduced proinflammatory cytokines (IL-6, p < 0.001; TNF-α, p < 0.001) and VAS scores (p < 0.001). The incidence of adverse events was comparable between groups.
conclusionLow-dose intraoperative intravenous esketamine safely mitigates postsurgical depressive symptoms in PD patients following non-intracranial surgery, potentially through synergistic modulation of serotoninergic activity and neuroinflammatory responses.
trial registrationhttp://www.chictr.org.cn , ChiCTR2500098063, Registration date: 3 March 2025. Retrospectively registratered.
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