Mostafa Raham Hasan, Khamis Ahmed Mohamed, Saleh Ashraf Nabil, Mekki Yehia Mamdouh Hassan, Kamal Mohamed Mohamed, Ibrahim Ismail Mohammed, Ismaiel Mohamed Abdulmohsen Abdulnaiem
Department of Anesthesia, Intensive Care and Pain Management, Ain Shams University, Cairo, Egypt.
Anesthesiol Res Pract. 2021 Mar 23;2021:6674658. doi: 10.1155/2021/6674658. eCollection 2021.
Emotional and psychological effects following abortion are more common than physical side effects and can range from mild regret to more serious complications such as depression. In the last decade, it has been suggested that low dose of ketamine is a fast-acting antidepressant.
The aim of this study was to investigate the impact of intraoperative ketamine infusion on postoperative mood score in patients undergoing Dilation and Curettage (D&C) under spinal anesthesia. We hypothesized that a single low-dose administration of ketamine infusion during D&C surgery can improve mood scores in the immediate postoperative period.
A prospective, randomized, double-blind, parallel-group, placebo-controlled trial. The study included a total of 60 patients, ≥18 years, physical status ASA II, with up to 12-week gestation undergoing elective D&C surgery. Patients were divided randomly into a ketamine group (group K) and a control group (group C). In group K, 0.4 mg/kg ketamine was given as a continuous infusion over 20 min intraoperatively. . Profile of Mood States (POMS) was recorded preoperatively and 2 hours postoperatively.
There were no differences in preoperative POMS between the two groups. Mean postoperative POMS of group K was lower than that of group C indicating mood improvement. Ketamine group patients showed higher sedation score and increased, although self-limiting, psychedelic phenomena than the control group.
Observed data here support an acute effect of ketamine on mood but any further claim will be speculative. Further future studies exploring postoperative mood scores after 24 hours post-infusion are needed. This trial is registered with PACTR201907779292947.
堕胎后的情绪和心理影响比身体副作用更常见,范围从轻微的后悔到更严重的并发症,如抑郁症。在过去十年中,有人提出低剂量氯胺酮是一种速效抗抑郁药。
本研究旨在探讨术中输注氯胺酮对脊髓麻醉下行刮宫术(D&C)患者术后情绪评分的影响。我们假设在D&C手术期间单次低剂量输注氯胺酮可改善术后即刻的情绪评分。
一项前瞻性、随机、双盲、平行组、安慰剂对照试验。该研究共纳入60例年龄≥18岁、身体状况为ASA II级、妊娠12周以内接受择期D&C手术的患者。患者被随机分为氯胺酮组(K组)和对照组(C组)。K组术中在20分钟内持续输注0.4mg/kg氯胺酮。术前和术后2小时记录情绪状态量表(POMS)。
两组术前POMS无差异。K组术后平均POMS低于C组,表明情绪有所改善。氯胺酮组患者的镇静评分高于对照组,且出现了虽为自限性但增多的幻觉现象。
此处观察到的数据支持氯胺酮对情绪有急性影响,但任何进一步的说法都只是推测。需要进一步开展研究探索输注后24小时的术后情绪评分。本试验已在泛非洲临床试验注册中心注册,注册号为PACTR201907779292947。