title: Single bolus low-dose of ketamine does not prevent postpartum depression: a randomized, double-blind, placebo-controlled, prospective clinical trial.
abstract: OBJECTIVE
  Postpartum depression is a common complication of childbirth. In the last decade, it has been suggested that subdissociative-dose ketamine is a fast-acting antidepressant. We aimed to investigate the efficacy of low-dose ketamine administered during caesarean section in preventing postpartum depression.
  
  
  METHODS
  Using a randomized, double-blind, placebo-controlled design, 330 parturients who were scheduled to undergo caesarean section were enrolled in this trial. The parturients were randomly assigned to receive intravenous ketamine (0.25 mg/kg diluted to 10 mL with 0.9% saline) or placebo (10 mL of 0.9% saline) within 5 min following clamping of the neonatal umbilical cord. The primary outcome was the degree of depression, which was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) (a threshold of 9/10 was used) at 3 days and 6 weeks after delivery. The secondary outcome was the numeric rating scale score of pain at 3 day and 6 week postpartum.
  
  
  RESULTS
  No significant differences were found in the prevalence of postpartum depression between the two groups at 3 days and 6 weeks after delivery. The pain scores measured at 3 days postoperatively were not significantly different between the groups, whereas the scores measured at 6 week postpartum were significantly reduced in the treatment group compared with the saline group (P = 0.014).
  
  
  CONCLUSIONS
  Intra-operative low-dose ketamine (0.25 mg/kg) does not have a preventive effect on postpartum depression.
authors.affiliation: Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China. sylyt6788@sina.com.
authors.forename: Yuantao
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China.
authors.forename: Daili
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 2004 Honglilu Road, Futian District, Shenzhen, China.
authors.forename: Baozuan
authors.initials: B
authors.lastname: She
authors.affiliation: Section of Anaesthetics, Pain Medicine & Intensive Care, Department of Surgery & Cancer, Faculty of Medicine, Chelsea & Westminster Hospital, Imperial College London, 369 Fulham Road, London, UK.
authors.forename: Daqing
authors.initials: D
authors.lastname: Ma
mesh_terms: D000328:Adult; D002585:Cesarean Section; D019052:Depression, Postpartum / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D007649:Ketamine
keywords: Caesarean section; Depression; Ketamine; Pain; Postpartum; Prevention and control