Bariatric Surgery, Depressed
Conditions
Keywords
esketamine, bariatric surgery, depression
Brief summary
The aim of this study is to observe the antidepressant effect of low-dose esketamine in obese patients with preoperative depression and seeking bariatric surgery. We speculate that intraoperative infusion and the addition of a small dose of esketamine to the postoperative analgesic pump can help reduce the proportion of patients with depression after surgery, and may further improve postoperative recovery, reduce the use of postoperative opioids, shorten postoperative hospital stay, and improve postoperative quality of life of patients.
Interventions
DRUGEsketamine
For the subjects in the experimental group, esketamine 50mg/2ml was diluted with normal saline up to 50ml (with a concentration of esketamine at 1mg/ml), anesthesia induction begins with intravenous infusion of esketamine 0.25mg/kg (0.375ml/kg•h drug preparation solution), with a pumping duration of 40 minutes.After the operation, esketamine 0.25mg/kg and sufentanil 1.5ug/kg were added to the postoperative analgesic pump dilute to 100ml with normal saline, with a background dose of 2ml/h and a single booster dose of 2ml.
DRUGDexmedetomidine
For the control group subjects, dexmedetomidine at a dose of 0.2mg/2ml was diluted with normal saline up to 50ml(dexmedetomidine concentration of 4μg/ml), anesthesia induction begins with intravenous infusion of 0.5μg/kg (0.083ml/kg•h), with a pumping duration of 40 minutes. The postoperative analgesic pump was added after the operation dilute with normal saline at a dose of 0.5μg/kg of dexmedetomidine and 1.5 μg/kg of sufentanil 100ml, with a background dose of 2ml/h and a single booster dose of 2ml.
Sponsors
The First Hospital of Jilin University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years old and \<65 years old * Patients with a BMI greater than 35 kg/m\^2 * Hamilton Depression score ≥7 points * Planned to undergo elective laparoscopic sleeve gastrectomy
Exclusion criteria
* ASA ≥ grade IV * Those who have had or are currently suffering from mental disorders other than anxiety and depression, such as schizophrenia, bipolar disorder, organic mental disorders, etc. * Those who are unable to cooperate in completing the scale assessment * Have received ketamine/esketamine treatment, or are allergic to ketamine/esketamine * Clarify ischemic cardiomyopathy or severe liver and kidney dysfunction (Child pugh grade C, CKD stage G5) * People with opioid dependence and those who have been taking various types of painkillers for a long time (more than 3 months) * Participate in other research
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hamilton Depression Scale ≥7 | Seven days after the operation | The proportion of patients with depression (Hamilton Depression score ≥7) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| the proportion of patients with depression | 30 days, 3 months, 6 month and 1 year after the operation | The proportion of patients with depression |
Countries
China
Contacts
STUDY_DIRECTORZhiwen Li, Doctor of Medicine
The First Hospital of Jilin University
Outcome results
None listed