Depressive symptoms
Conditions
Interventions
Intervention group (esketamine group):Perioperative administration of esketamine, including loading doses during anesthesia induction and continuous intravenous infusion during surgery.
Control group (normal saline group):All patients were given equal volumes of physiological saline (0.9% NaCl) at the same rate.
Sponsors
Zhongshan Hospital, Fudan University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1.Age 18-80 years; 2.Elective off-pump coronary artery bypass grafting under general anesthesia; 3.ASA classification II-IV; 4.Normal preoperative cognitive function (MMSE >= 24 points); 5.Signed informed consent form.
Exclusion criteria
Exclusion criteria: 1. Those who have been previously diagnosed with severe mental disorders (schizophrenia, bipolar disorder) or major depression and are currently taking medication; . 2. Severe cardiovascular risk: Uncontrolled hypertension (SBP>180 mmHg and/or DBP>110 mmHg), severe left main coronary artery disease (stenosis >50%), severe aortic stenosis, resting heart rate >100 bpm; 3. Neurological contraindications: Intracranial hypertension, intracranial tumors, cerebral vascular malformations, untreated aneurysms, history of epilepsy; 4. Severe liver and kidney dysfunction (Child-Pugh grade C or eGFR <15 mL/min/1.73m^2); 5. A history of severe glaucoma or penetrating eyeball injuries; 6. There is a history of abuse/dependence on ketamine, opioids or psychoactive substances in the past; 7. Allergic to esketamine or any excipients; 8. Emergency surgery, heart transplantation, and deep hypothermic circulatory arrest surgery; 9. Pregnant and lactating women; 10. The researchers determined that there were other conditions where the use of esketamine was not suitable (such as severe untreated hyperthyroidism);
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of clinically significant depressive symptoms within 7 days postoperatively; | — |
Secondary
| Measure | Time frame |
|---|---|
| The severity of depression and quality of life;Neuroimmune inflammatory indicators (BDNF, IL-6, TNF-a);Pain indicators;Cognitive function indicators;ICU stay time (h);Total length of hospital stay (d);Intraoperative hemodynamic abnormalities;Postoperative delirium;Mental nomenclature symptoms; | — |
Countries
China
Contacts
Public ContactMiao Changhong
Zhongshan Hospital, Fudan University
Outcome results
None listed