Pregnant women who are admitted to the hospital in the third trimester for delivery preparation, have an EPDS score of =10 points, and are scheduled for elective cesarean section.
Conditions
Interventions
The Esketamine Group:After the fetus is delivered and the umbilical cord is cut, 5 ml of 0.2 mg/kg esketamine is injected through the established intravenous indwelling needle channel. After the cesar
The Normal Saline Group:After the fetus is removed and the umbilical cord is cut, 5 ml of 0.9% sodium chloride injection is administered intravenously through the venous access. After the cesarean sec
Sponsors
The Second Affiliated Hospital of Guangdong Medical University
Eligibility
Sex/Gender
Female
Age
18 Years to 40 Years
Inclusion criteria
Inclusion criteria: Aged >=18 years old, with full capacity for civil conduct, capable of understanding and signing the informed consent form; women undergoing elective cesarean section; admitted to the hospital in the late stage of pregnancy (gestational age =37 weeks) for labor; with a score of =10 on the Edinburgh Postnatal Depression Scale (EPDS) at admission, indicating the presence of prenatal depression symptoms; with an ASA (American Society of Anesthesiologists) classification of I-II, able to accept postoperative PCA analgesia management; agree to participate in this study and sign a written informed consent form.
Exclusion criteria
Exclusion criteria: A clear history of mental illness diagnosis in the past (such as major depressive disorder, schizophrenia, bipolar disorder, etc.); currently taking antidepressants, antipsychotics or other drugs that affect the central nervous system; having severe complications during pregnancy (such as severe preeclampsia, placental abruption, HELLP syndrome, etc.); allergic to ketamine or sufentanil and other anesthetic analgesic drugs, or having related contraindications; having severe heart, liver, kidney function disorders or a history of epilepsy; ASA classification >= III, not suitable for postoperative PCA analgesia treatment; having a history of drug abuse or other behaviors that may interfere with the judgment of research results; unwilling to cooperate with the research or expected to be unable to complete the research follow-up.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The improvement rate of EPDS score within 30 days postpartum; | — |
Secondary
| Measure | Time frame |
|---|---|
| Adverse reactions: nausea, vomiting, dizziness, respiratory depression, mental side effects, etc.;Pain relief effect and total dosage of opioids: VAS/NRS pain relief scores were conducted at 6 hours, 24 hours, and 48 hours postoperatively, and the total dosage of opioids during the pain relief period was recorded simultaneously.;Patient satisfaction: On the third day and the thirtieth day postpartum, the patients' subjective satisfaction with the improvement of their mood, pain relief experience and overall recovery was evaluated.;Emotional indicators: The degree of depressive symptoms in postpartum women was evaluated using the EPDS and HAMD-17 scales respectively on the 30th day after delivery.; | — |
Countries
China
Contacts
Public ContactCaihua Zeng
The Second Affiliated Hospital of Guangdong Medical University
Outcome results
None listed