Abstract：
Depression is a significant factor contributing to postoperative occurrences, and patients diagnosed with depression have a higher risk for postoperative complications. Studies on cardiovascular surgery extensively addresses this concern. Several studies report that people who undergo coronary artery bypass graft surgery have a 20% chance of developing postoperative depression. A retrospective analysis of medical records spanning 21 years, involving 817 patients, revealed that approximately 40% of individuals undergoing coronary artery bypass grafting (CABG) were at risk of perioperative depression. Patients endure prolonged suffering from illness because each attempt with standard antidepressants requires several weeks to be effective. In addition, multi-drug combination adjuvants or combination medication therapy may alleviate symptoms for some individuals, but they also increase the risk of side effects. Conventional antidepressants primarily modulate the monoamine system, whereas different therapies target the serotonin, norepinephrine, and dopamine systems. Esketamine is a fast-acting antidepressant with high efficacy. Esketamine is the S-enantiomer of ketamine, a derivative of phencyclidine developed in 1956. Esketamine exerts its effect by targeting the glutaminergic system the glutaminergic system. In this paper, we discuss the current depression treatment strategies with a focus on the pharmacology and mechanism of action of esketamine. In addition, studies reporting use of esketamine to treat perioperative depressive symptoms are reviwed, and the potential future applications of the drug are presented.
摘要：
抑郁是导致术后发生的重要因素，诊断为抑郁症的患者术后并发症的风险更高。心血管手术的研究广泛解决了这一问题。一些研究报告说，接受冠状动脉搭桥手术的人有20％的机会发生术后抑郁症。对21年的病历进行回顾性分析，涉及817名患者，显示，大约40％的人接受冠状动脉旁路移植术（CABG）有围手术期抑郁的风险。患者忍受长期的疾病痛苦，因为每次尝试使用标准抗抑郁药需要数周才能有效。此外,多药联合佐剂或联合药物治疗可以缓解一些个体的症状，但它们也会增加副作用的风险。传统的抗抑郁药主要调节单胺系统，而不同的疗法针对血清素，去甲肾上腺素,和多巴胺系统。Esketamine是一种快速作用的抗抑郁药，具有很高的疗效。Esketamine是氯胺酮的S-对映体,1956年开发的苯环利定的衍生物。Esketamine通过靶向谷氨酸能系统发挥其作用。在本文中,我们讨论了目前的抑郁症治疗策略，重点是艾氯胺酮的药理学和作用机制。此外,报道使用艾氯胺酮治疗围手术期抑郁症状的研究得到了恢复，并介绍了该药物的潜在应用前景。
