The Efficacy of Sub-Anesthesia S-Ketamine on Postoperative Depressive Symptoms in Patients Undergoing Abdominal Tumor...

Cancer patients undergoing major surgery often have perioperative depression symptoms, and are associated with worsened outcomes.

We aimed to evaluate the efficacy of S-ketamine in alleviating depressive symptoms after abdominal Tumor surgery.

A prospective, double-blind, placebo-controlled randomized trial was conducted, enrolling 230 patients with newly screened mild-to-severe depressive symptoms scheduled for abdominal tumor resection. Participants were randomly assigned to receive either 0.4 mg/kg of S-ketamine or normal saline. The primary outcome was the difference in treatment response rates, which defined as a 50% decrease from baseline in Patient Health Questionnaire-9 (PHQ-9) on postoperative day (POD) 1. Secondary outcomes included global quality of recovery (QoR-15) scores and adverse events. Group-based trajectory modeling was used to identify the potential trajectories of depression severity over the postoperative 7-day and the risk factors were also analyzed.

On POD 1, the S-ketamine group demonstrated a slightly higher treatment response (odds ratio [OR], 1.4 [95% confidence interval (CI), 0.8 to 2.6], p = 0.017), a reduction in PHQ-9 scores (MD -1.0 [95% CI, -2.0 to 0]; p = 0.002) and higher QoR-15 scores (MD -2.2 [95% CI: -4.3 to -0.7]; p = 0.043). However, the treatment responses, PHQ-9 scores and QoR-15 scores were similar on POD 3 and 7. Adverse events were comparable between the two groups. Additionally, logistic regression did not indicate significant associations between treatment allocation.

This study found the effects of sub-anesthesia S-ketamine on depressive symptoms in this patient population postoperatively were limited. The long-term efficacy needs to be explored.

Chinese Clinical Trial Registry Identifier: ChiCTR 2200065298.