Intraoperative Low-dose S-ketamine Reduces Depressive Symptoms in Patients with Crohn’s Disease Undergoing Bowel Resection: A Randomized Controlled Trial

Abstract

Purpose We aim to investigate the effect of S-ketamine preconditioning on postoperative depression in patients with CD undergoing bowel resection with mild to moderate depression and to observe whether it can relieve postoperative pain and anti-inflammation. Methods A total of 120 adult patients were randomised in to one of the two groups; Patients in the S-ketamine group received 0.25mg/kg S-ketamine intravenous drip under general anesthesia induction, followed by continuous infusion of S-ketamine with 0.12mg/kg/h for more than 30 minutes through target-controlled infusion. Patients in the placebo group received 0.9% saline. The patients in both groups were evaluated by depression scale, pain scale and inflammatory factors at set intervals during a total period of one month starting from the end of operation. Results There was no significant difference in preoperative age, sex, body mass index (BMI), PHQ-9, and HAMD-17 scores between the two groups (P > 0.05). The scores of PHQ-9 and HAMD-17 in the S-ketamine group were lower than those in the placebo group on the 1st, 3rd, and 7th day postoperatively (P < 0.05). There was no significant difference in PHQ-9 and HAMD-17 scores between the two groups one month postoperatively (P > 0.05). The NRS scores of PACU, 1 day and 2 days postoperatively in the S-ketamine group were lower than those in the placebo group (P < 0.05). There was no significant difference in NRS score between the two groups at 7 days postoperatively (P > 0.05). There was no significant difference in postoperative complications, hospital stay, CRP, and IL-6 levels on the 1st and 3rd day postoperatively between the two groups (P > 0.05). Conclusion In patients with Crohn’s disease undergoing bowel resection with mild to moderate depression, intraoperative infusion of low-dose S-ketamine was effective in relieving depression one week after surgery and reducing postoperative pain two-day.

Hotel Capacity Planning Using Queuing Systems and Meta-Heuristic Algorithms

“…For example, Tirkolaee et al [21], using optimization methods, to measure the efficiency of some decision-making units, found that the capacity and scale were among the cases for measuring the efficiency of such units and their perspectives. The application of optimization to evaluate system conditions has been further observed in other studies, too [22][23][24].…”

“…Considering the fact that the suggested model is on the basis of the queuing concepts, the hotel and its reception and accommodation system should be adapted to the queuing system components [13,22].…”

“…Although approximation algorithms to solve multidimensional backpack problems are iterative, they do not guarantee optimal responses, but produce acceptable approximate ones in most cases. One of the iterative algorithms considered by researchers in many studies [13,22] is the genetic algorithm (GA). Therefore, it was used in this article to solve the proposed two-dimensional backpack model.…”