Postoperative Depression
Conditions
Interventions
Placebo group (Group 1):Intravenous injection of normal saline with corresponding volume before anesthesia + intravenous injection of normal saline with equal volume after anesthesia
Pre-anesthesia ES group (Group 2):Intravenous injection of 0.5 mg/kg esketamine before anesthesia + intravenous injection of normal saline with equal volume after anesthesia
Post-anesthesia ES group (Group 3):Intravenous injection of normal saline with equal volume before anesthesia + intravenous injection of 0.5 mg/kg esketamine after anesthesia
Sponsors
Third Xiangya Hospital, Central South University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Aged >= 18 years, undergoing elective non-cardiac thoracic surgery; 2.Patients with mild to severe depressive symptoms preoperatively, i.e., PHQ-9 score > 4; 3.Surgery with an anticipated anesthesia duration > 120 minutes; 4.Undergoing the first elective general anesthesia surgery only during the current hospitalization; 5.ASA physical status classification ?-?; 6. Subjects who fully understand the benefits and risks of this trial, are willing to participate, and have signed the informed consent form.
Exclusion criteria
Exclusion criteria: 1. Allergy to NMDA receptor antagonists; 2.Current or past history of schizophrenia, bipolar disorder, or anesthetic abuse; 3.Uncontrolled hypertension (SBP > 160 mmHg/DBP > 100 mmHg) or extremely high risk in hypertension risk stratification; 4. Contraindications to esketamine use, such as risks of increased intraocular pressure or intracranial pressure (e.g., glaucoma, brain tumor, recent craniocerebral injury); 5. Pregnant or lactating women; 6.Inability or unwillingness to cooperate with questionnaires and clinical examinations; 7. Severe agitation or delirium before surgery; 8. Receiving antipsychotic treatment or having conditions requiring emergency psychiatric intervention before surgery (e.g., acute depressive episode, suicide risk, etc.); 9.Body mass index (BMI) > 30 kg/m^2.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 17 item Hamilton depression rating scale(17-HAMD); | — |
Secondary
| Measure | Time frame |
|---|---|
| agitation;PACU delirium;adverse mental symptoms during the emergence period;17 item Hamilton depression rating scale(17-HAMD);postoperative sleep;postoperative pain;postoperative nausea and vomiting;postoperative opioid consumption;length of postoperative hospital stays and total hospital stays;EEG characteristics;Serum brain-derived neurotrophic factor levels;hs-CRP;To be determined blood test indicators; | — |
Countries
China
Contacts
Public ContactOuyang Wen; Liu Xing; Chen Jia
Third Xiangya Hospital, Central South University
Outcome results
None listed