Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou, China.
BMC Psychiatry. 2024 Aug 27;24(1):582. doi: 10.1186/s12888-024-06035-0.
Patients with Postherpetic Neuralgia (PHN) often exhibit depressive-like symptoms, significantly impacting their quality of life. Esketamine, known for its analgesic properties, has also been recognized for its rapid antidepressant effects. However, its efficacy in the treatment of PHN requires further exploration. This study aims to evaluate the impact of intravenous patient-controlled analgesia(PICA) with esketamine on depressive mood in PHN patients.
This retrospective study analyzed PHN patients hospitalized and treated at the affiliated hospital of Southwest Medical University from June 2021 to March 2023. Patients were divided into the esketamine group (E group) and the sufentanil group (S group) based on their treatment regimens. Primary outcomes included pain numerical rating scale(NRS), depression patient health questionaire-9(PHQ-9), and anxiety generalized anxiety disorder-7(GAD-7) scores measured before treatment, and at 3 days, 7 days, 1 month, 2 months, and 3 months post-treatment.
A total of 83 patients were included in the analysis. Before treatment, there were no statistically significant differences in pain NRS, depression PHQ-9, and anxiety GAD-7 scores between the two groups (P > 0.05). Compared to before treatment, significant reductions in pain NRS scores were observed at all post-treatment time points in both groups (P < 0.05), with no differences between groups (P > 0.05). The E group exhibited significantly lower depression PHQ-9 scores than the S group at 3 days and 7 days post-treatment (P < 0.05), but no significant differences were observed at 1 month, 2 months, and 3 months (P > 0.05). Anxiety GAD-7 scores were significantly lower in the E group compared to the S group at 3 days, 7 days post-treatment (P < 0.05), with no statistical differences at 1 month, 2 months, and 3 months post-treatment (P > 0.05).
Both PICA with esketamine and sufentanil alleviated pain equally in PHN patients. However, PICA with esketamine specifically improved early symptoms of anxiety and depression.
带状疱疹后神经痛（PHN）患者常表现出抑郁样症状，显著影响其生活质量。氯胺酮具有镇痛作用，也被认为具有快速抗抑郁作用。然而，其在 PHN 治疗中的疗效仍需进一步探索。本研究旨在评估静脉自控镇痛（PICA）氯胺酮对 PHN 患者抑郁情绪的影响。
本回顾性研究分析了 2021 年 6 月至 2023 年 3 月在西南医科大学附属医院住院治疗的 PHN 患者。根据治疗方案将患者分为氯胺酮组（E 组）和舒芬太尼组（S 组）。主要结局指标包括治疗前、治疗后 3 天、7 天、1 个月、2 个月和 3 个月的疼痛数字评分量表（NRS）、抑郁患者健康问卷-9（PHQ-9）和焦虑通用焦虑障碍-7（GAD-7）评分。
共纳入 83 例患者。治疗前，两组疼痛 NRS、抑郁 PHQ-9 和焦虑 GAD-7 评分无统计学差异（P＞0.05）。与治疗前相比，两组在治疗后各时间点的疼痛 NRS 评分均显著降低（P＜0.05），两组间无差异（P＞0.05）。E 组治疗后 3 天和 7 天的抑郁 PHQ-9 评分明显低于 S 组（P＜0.05），但 1 个月、2 个月和 3 个月时差异无统计学意义（P＞0.05）。E 组治疗后 3 天和 7 天的焦虑 GAD-7 评分明显低于 S 组（P＜0.05），1 个月、2 个月和 3 个月时差异无统计学意义（P＞0.05）。
PICA 氯胺酮和舒芬太尼均能缓解 PHN 患者的疼痛，PICA 氯胺酮可特异性改善焦虑和抑郁的早期症状。
