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The effect of low-dose esketamine on maternal depression after cesarean delivery

Yan Shang, Siyuan Li, Qin Zheng, T. MAHALAKSH MI, Yan Lv, Lichun Han, Binrong Wang

2025Journal of Psychosomatic Obstetrics & Gynecology8 citationsDOIOpen Access PDF

Abstract

OBJECTIVE: To assess the impact of low-dose intravenous esketamine on postpartum depression scores in women undergoing cesarean section. METHODS: In a randomized, double-blind, placebo-controlled trial, 186 women aged 20-50 years receiving epidural anesthesia for cesarean section were divided into three groups: Group A (0.25 mg/kg esketamine intraoperatively + esketamine in PCIA), Group B (0.25 mg/kg esketamine intraoperatively + PCIA without esketamine), and Group C (placebo intraoperatively + PCIA without esketamine). The primary outcome was the change in Edinburgh Postnatal Depression Scale (EPDS) scores. Secondary outcomes included Pittsburgh Sleep Quality Index (PSQI) scores, Visual Analogue Scale (VAS) scores, PCIA bolus frequency, and adverse events. RESULTS: < 0.01). No significant differences were observed in PSQI scores, VAS scores or PCIA bolus frequency between groups. Adverse events though mild and transient, were more frequent in Group A (p < 0.01). CONCLUSION: Low-dose intravenous esketamine, reduces postpartum depression scores post-cesarean section, with a safe profile despite increased mild adverse events when combined with PCIA.

Topics & Concepts

Cesarean deliveryDepression (economics)MedicineObstetricsPregnancyAnesthesiaMacroeconomicsEconomicsGeneticsBiologyTreatment of Major DepressionMaternal Mental Health During Pregnancy and PostpartumAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes