Use of Various Doses of S-Ketamine in Treatment of Depression and Pain in Cervical Carcinoma Patients with Mild/Moderate Depression After Laparoscopic Total Hysterectomy

Wang, Jie; Wang, Y.; Xu, Xudong; Peng, Sheng; Xu, Feng; Liu, Peirong

doi:10.12659/msm.922028

Cited by 38 publications

(72 citation statements)

References 27 publications

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“…Generally, the dose of esketamine is 0.25 or 0.5 mg/kg (25,26). In cervical carcinoma patients, both 0.5 and 0.25 mg/kg esketamine improved short-term depression and pain after surgery, showing no difference between the 2 groups (27). In contrast, esketamine was reported to reduce the consumption of an opioid in a dosedependent manner in patients who underwent major lumbar fusion surgery (28).…”

Section: Discussionmentioning

confidence: 99%

Effect of low-dose esketamine on pain control and postpartum depression after cesarean section: a retrospective cohort study

Wang¹,

Zhang²,

Xu³

et al. 2022

Ann Palliat Med

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Background: Esketamine is used to control postoperative pain and reduce postoperative depression in surgical patients. This study was performed to determine the effects of esketamine on pain control as well as postpartum depression (PPD) in pregnant women who underwent cesarean section (CS).Methods: Pregnant women who underwent CS between March 2018 and February 2020 at our hospital were retrospectively reviewed. Parturients in the control group received 50 µg sufentanil citrate and 0.25 mg palonosetron hydrochloride, while those in the experimental group received additional 0.2-0.5 mg/kg esketamine. The primary outcomes included postoperative pain control according to the numeric rating scale (NRS) and the incidence of PPD according to the Edinburgh postnatal depression scale (EPDS).Multivariable linear regression analysis was performed to determine the relationship between the use of esketamine, pain control, and the incidence of PPD after CS.Results: There were 132 parturients in the control group and 108 parturients in the esketamine group in this study. All NRS scores at rest at any time point were much lower in the esketamine group than those in the control group. Besides, NRS scores when coughing were also lower in the esketamine group within 24 hours. EPDS scores were lower in the esketamine group than those in the control group within 3 months postpartum. Esketamine acted as a protector of pain control and was confirmed to improve the incidence of PPD using multivariable linear regression. Parturients had dramatically better sleep quality within 1 week postpartum (P=0.044), and morphine consumption within 24 hours postpartum was lower in the esketamine group than in the control group (P<0.001). The quality of recovery within 3 months postpartum was also better in the esketamine group (P=0.001). A subgroup analysis of 2 subgroups divided according to the dose of esketamine was then performed, indicating no significant difference between the low-dose group and high-dose group in most included outcomes.Conclusions: This study confirmed the effects of esketamine on pain control and the incidence of PPD in pregnant women who underwent CS. Considering the potential adverse events, low-dose esketamine may be more suitable for pregnant women who have undergone CS.

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Section: Discussionmentioning

confidence: 99%

Effect of low-dose esketamine on pain control and postpartum depression after cesarean section: a retrospective cohort study

Wang¹,

Zhang²,

Xu³

et al. 2022

Ann Palliat Med

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“…Of these, 590 were discarded after reviewing titles and abstracts. Of the remaining 58 full-text articles, 24 met the inclusion criteria ( Ajub and Lacerda, 2018 ; Barbosa et al, 2020 ; Bartova et al, 2018 , 2015 ; Correia-Melo et al, 2017a , 2017b , 2020 ; Del Sant et al, 2020 ; Delfino et al, 2021 ; Falk et al, 2020 ; Findeis et al, 2020 ; Kallmünzer et al, 2016 ; Kavakbasi et al, 2021 ; Lewis et al, 2019 ; Liu et al, 2020 ; Lucchese et al, 2021 ; Paslakis et al, 2010 ; Paul et al, 2009 ; Ritter et al, 2020 ; Segmiller et al, 2013 ; Singh et al, 2016 ; Veraart et al, 2021a ; Vieira et al, 2021 ; Wang et al, 2020 ). Nine articles included the same four cohorts of patients.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included patients with a depressive episode in the course of MDD or bipolar disorder (BD) and some degree of treatment resistance. In four studies, besides meeting criteria for depression, patients underwent palliative care or cancer treatment ( Barbosa et al, 2020 ; Falk et al, 2020 ; Liu et al, 2020 ; Wang et al, 2020 ). The severity of depressive symptoms was mostly measured by the Montgomery–Åsberg Depression Rating Scale (MADRS) or Hamilton Depression Rating Scale (HDRS).…”

Section: Resultsmentioning

confidence: 99%

“…Two RCTs compared a single IV injection of esketamine to both racemic ketamine and placebo (saline) in patients with cancer and mild-to-moderate depressive symptoms ( Liu et al, 2020 ; Wang et al, 2020 ). In the study by Liu et al (2020) , HDRS 17 scores were lower after 0.125 mg/kg esketamine compared to 0.125 mg/kg racemic ketamine and placebo at 3 days, 1 week, and 1 month follow-up, but not at 3 months follow-up.…”

Section: Resultsmentioning

confidence: 99%

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The antidepressant effect and safety of non-intranasal esketamine: A systematic review

et al. 2022

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Background: The introduction of esketamine into the field of psychiatry comes on the heels of excitement from studies on racemic ketamine. While the intranasal route has been the most studied to date, other modes of administration of esketamine may also be of interest in the management of depression. Aims: To systematically review the literature on non-intranasal esketamine for depression in terms of its antidepressant effect and safety. Methods: We searched PubMed, Embase, the Cochrane Library, and Google Scholar from inception up to February 2021. Search terms included a combination of Medical Subject Headings and text words indicative of esketamine and depression. We selected both controlled and uncontrolled studies examining non-intranasal esketamine for the treatment of depression. Results: We identified four randomized controlled trials (RCTs) on intravenous esketamine and 15 open-label studies on intravenous ( n = 80), subcutaneous ( n = 73), and oral ( n = 5) esketamine. We found intravenous, subcutaneous, and possibly oral administration of esketamine to be effective in reducing depressive symptoms in most patients with major depressive disorder, bipolar depression, and (severe) treatment-resistant depression. Clinical response to repeated administration of esketamine persisted over the course of treatment. Esketamine was well tolerated by most patients, but open-label data indicate marked psychotomimetic symptoms in exceptional cases. The overall quality of the controlled studies was considered high, the overall quality of the uncontrolled studies low to moderate. Conclusions: Intravenous, subcutaneous, and possibly oral esketamine may offer an effective and safe addition to the depression treatment armamentarium. However, as most included studies lacked a control group and had small sample sizes, the quality of our results is limited. Different types and formulations of ketamine remain to be compared directly.

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“…Total effective rate � (CR + PR)/total number of cases. A visual analogue scale [11] (VAS) was used to assess the pain level of cervical cancer patients at 1 d, 7 d, 30 d, and 60 d postoperatively, and patients were asked to mark the position representing their pain level in a 10 cm walking scale (with the scale face back to the patient), with a score of 0 being no pain and 10 being the most severe pain; the higher the score, the more severe the pain level. e Symptom Checklist 90 (SCL-90) [12] was used to evaluate changes in patients' psychological stress levels.…”

Section: Observation Indicatormentioning

confidence: 99%

Effect of Psychological Care Combined with Traditional Chinese Medicine on Postoperative Psychological Stress Response in Patients with Advanced Cervical Cancer

Hou

Zhang

Nie

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To study the effects of psychological care combined with traditional Chinese medicine treatment on the postoperative psychological stress response and the expression levels of serum C-reactive protein (CRP) and interferon-γ (IFN-γ) in patients with advanced cervical cancer. Method. 232 postoperative advanced cervical cancer patients treated in our hospital from December 2015 to December 2018 were selected as study objects and divided into the control group and study group using the random number table method. The control group was given basic care combined with traditional Chinese medicine treatment, while the study group was given psychological care treatment on the basis of the control group to compare the treatment effect, psychological stress response, pain level, quality of life, and long-term efficacy of the two groups. The serum CRP and IFN-γ levels and their correlation with different psychological stress responses were compared between the two groups before and after treatment. Result. Comparing the clinical efficacy of the two groups, the total effective rate of the study group was higher than that of the control group. VAS scores in the study group were significantly lower than those in the control group 30 and 60 days after treatment. The SCL-90 scores of the study group after treatment were lower than those of the control group. After treatment, the differences between the two groups were statistically significant in the scores of emotional function, social function, and role function. The two-year cumulative survival rate in the study group (82.76%) was significantly increased compared to that in the control group (55.17%). The serum CRP and IFN-γ expression levels in the two groups were significantly decreased after treatment compared to those before treatment, and the serum CRP and IFN-γ expression levels in the study group were significantly decreased compared to those in the control group. Conclusion. Psychological care combined with traditional Chinese medicine in the treatment of advanced cervical cancer patients after surgery was effective in improving patients’ psychological status, reducing their pain level, relieving postoperative negative emotions, increasing compliance, improving the quality of life, helping to prolong survival time, and controlling serum indexes back to normal, which was worth promoting in clinical practice.

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Use of Various Doses of S-Ketamine in Treatment of Depression and Pain in Cervical Carcinoma Patients with Mild/Moderate Depression After Laparoscopic Total Hysterectomy

Cited by 38 publications

References 27 publications

Effect of low-dose esketamine on pain control and postpartum depression after cesarean section: a retrospective cohort study

Effect of low-dose esketamine on pain control and postpartum depression after cesarean section: a retrospective cohort study

The antidepressant effect and safety of non-intranasal esketamine: A systematic review

Effect of Psychological Care Combined with Traditional Chinese Medicine on Postoperative Psychological Stress Response in Patients with Advanced Cervical Cancer

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