4.7 Article

Evaluation of clinical effects of Esketamine on depression in patients with missed miscarriage: A randomized, controlled, double-blind trial

Journal

JOURNAL OF AFFECTIVE DISORDERS
Volume 329, Issue -, Pages 525-530

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ELSEVIER
DOI: 10.1016/j.jad.2023.02.127

Keywords

Esketamine; Depression; Missed miscarriage; Edinburgh postnatal depression scale

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This study investigated whether Esketamine could alleviate postoperative depression symptoms in patients with missed miscarriages who underwent painless curettage. The results showed that Esketamine effectively treated postoperative depressive symptoms, decreased propofol consumption, and reduced inflammatory response.
Background: Patients with missed miscarriages are usually accompanied by varying degrees of depression, which is closely related to the patient's prognosis. We investigated whether Esketamine could alleviate postoperative depression symptoms in patients with missed miscarriages who underwent painless curettage.Methods: This study was a randomized, parallel-controlled, double-blind, single-center trial. A total of 105 pa-tients with preoperative 1d (EPDS) >= 10 were randomly assigned to the Propofol; Dezocine; Esketamine group. Patients record EPDS at 7 and 42 days after the operation. Secondary outcomes included VAS for 1 h post-operation, total propofol usage, adverse reactions, And the expressions of inflammatory factors of TNF-alpha, IL-1 beta, IL-6, IL-8, and IL-10.Results: Compared with the P and D group, patients in the S group had lower EPDS scores at 7 day (8.63 +/- 3.14, 9.17 +/- 3.23 vs. 6.34 +/- 2.87 P = 0.0005) and 42 days (9.40 +/- 2.67, 8.49 +/- 3.05 vs.5.31 +/- 2.49 P < 0.0001) after the operation. Respectively, Compared with the P group, the VAS scores (3.51 +/- 1.12 vs. 2.80 +/- 0.83, 2.40 +/- 0.81, P = 0.0035) and the dosage of propofol used during operation (198.7 +/- 47.48 vs. 145.5 +/- 19.31, 142.9 +/- 21.01 P < 0.0001) were lower in the D and S groups, and lower postoperative inflammatory response at 1 day after surgery. Other outcomes among the three groups were not found to the difference.Conclusions: Esketamine effectively treated postoperative depressive symptoms of patients with a missed miscarriage, decreasing propofol consumption and inflammatory response.

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