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Abstract：
BACKGROUND: Breast cancer is the most common malignant tumor in females worldwide. During disease development, breast cancer patients suffer anxious and depressed, which may lead to worse quality of life or even higher mortality. Esketamine has been regarded as an antidepressant in breast cancer patients with mild or moderate depression. Here, we wonder whether the administration of esketamine could reduce the postoperative depressive symptom score of breast cancer patients who have no preoperative depression.
METHODS: A total of 64 patients treated with unilateral modified radical mastectomy were randomly divided into an experimental group (esketamine group, Group E) and a control group (Group C), with 32 cases in each one. After anesthesia induction, Group C received 0.2 ml/kg of normal saline intravenously and Group E was administered 0.2 mg/kg intravenous esketamine. The primary outcome was the Patient Health Questionnaire-9 (PHQ-9) scores. The secondary outcomes included the Visual Analogue Scale (VAS) scores for pain, inflammatory markers, perioperative-related indicators, and the incidence of postoperative delirium, nausea and vomiting.
RESULTS: The PHQ-9 score on postoperative day (POD) 1 in Group E declined from the preoperative level, while the score in Group C was higher than before, and the former was far lower than the latter (P = 0.047). There is no statistically significant difference in PHQ-9 scores between Group E and Group C on POD 3, 7, and 30. Moreover, the postoperative leukocyte level of Group E was higher than that of Group C, and the difference was statistically significant (P = 0.030).
CONCLUSIONS: A single subanesthetic dose of esketamine can result in lower postoperative score on subthreshold depressive symptoms compared to the Group C on POD 1, without increasing the occurrence of postoperative adverse reactions.
BACKGROUND: Registration number: Chinese Clinical Trial Registry ChiCTR2200057028. Date of registration: 26/02/2022.
METHODS: A total of 64 patients treated with unilateral modified radical mastectomy were randomly divided into an experimental group (esketamine group, Group E) and a control group (Group C), with 32 cases in each one. After anesthesia induction, Group C received 0.2 ml/kg of normal saline intravenously and Group E was administered 0.2 mg/kg intravenous esketamine. The primary outcome was the Patient Health Questionnaire-9 (PHQ-9) scores. The secondary outcomes included the Visual Analogue Scale (VAS) scores for pain, inflammatory markers, perioperative-related indicators, and the incidence of postoperative delirium, nausea and vomiting.
RESULTS: The PHQ-9 score on postoperative day (POD) 1 in Group E declined from the preoperative level, while the score in Group C was higher than before, and the former was far lower than the latter (P = 0.047). There is no statistically significant difference in PHQ-9 scores between Group E and Group C on POD 3, 7, and 30. Moreover, the postoperative leukocyte level of Group E was higher than that of Group C, and the difference was statistically significant (P = 0.030).
CONCLUSIONS: A single subanesthetic dose of esketamine can result in lower postoperative score on subthreshold depressive symptoms compared to the Group C on POD 1, without increasing the occurrence of postoperative adverse reactions.
BACKGROUND: Registration number: Chinese Clinical Trial Registry ChiCTR2200057028. Date of registration: 26/02/2022.
摘要：
背景：乳腺癌是全球女性最常见的恶性肿瘤。在疾病发展过程中,乳腺癌患者焦虑抑郁,这可能导致更差的生活质量甚至更高的死亡率。依斯克他明被认为是轻度或中度抑郁症的乳腺癌患者的抗抑郁药。这里,我们想知道给予艾氯胺酮是否可以降低术前没有抑郁的乳腺癌患者的术后抑郁症状评分。
方法:将64例行单侧乳腺癌改良根治术的患者随机分为实验组(艾氯胺酮组,E组）和对照组（C组），每个案例有32个。麻醉诱导后,C组静脉注射生理盐水0.2ml/kg，E组静脉注射艾氯胺酮0.2mg/kg。主要结果是患者健康问卷-9（PHQ-9）评分。次要结果包括疼痛的视觉模拟评分（VAS）评分，炎症标志物，围手术期相关指标，术后谵妄的发生率，恶心和呕吐。
结果：E组术后第1天PHQ-9评分（POD）较术前下降，而C组的得分高于以前，前者远低于后者(P=0.047)。在POD3、7和30上，E组和C组之间的PHQ-9评分没有统计学上的显着差异。此外，术后白细胞水平E组高于C组,差异有统计学意义(P=0.030)。
结论：与C组相比，单剂量亚麻醉药的艾氯胺酮可导致低于POD1组的术后阈下抑郁症状评分，而不增加术后不良反应的发生。
背景：注册号：中国临床试验注册中心ChiCTR2200057028。注册日期：2022年2月26日。
方法:将64例行单侧乳腺癌改良根治术的患者随机分为实验组(艾氯胺酮组,E组）和对照组（C组），每个案例有32个。麻醉诱导后,C组静脉注射生理盐水0.2ml/kg，E组静脉注射艾氯胺酮0.2mg/kg。主要结果是患者健康问卷-9（PHQ-9）评分。次要结果包括疼痛的视觉模拟评分（VAS）评分，炎症标志物，围手术期相关指标，术后谵妄的发生率，恶心和呕吐。
结果：E组术后第1天PHQ-9评分（POD）较术前下降，而C组的得分高于以前，前者远低于后者(P=0.047)。在POD3、7和30上，E组和C组之间的PHQ-9评分没有统计学上的显着差异。此外，术后白细胞水平E组高于C组,差异有统计学意义(P=0.030)。
结论：与C组相比，单剂量亚麻醉药的艾氯胺酮可导致低于POD1组的术后阈下抑郁症状评分，而不增加术后不良反应的发生。
背景：注册号：中国临床试验注册中心ChiCTR2200057028。注册日期：2022年2月26日。
