Effect of Esketamine on Hypotension in Women With Preoperative Anxiety Undergoing Elective Cesarean Section: A Randomized, Double-Blind, Controlled Trial

Authors

Yu Qi
Meiyan Zhou
Yaqi Dong
Wenting Zheng
Qinyu Jiang
Yanyu Li
Xinghe Wang
Jia Sun
Hai Zhou
Zhengquan Hu
Liwei Wang

Publication Date

7-24-2024

Journal

Scientific Reports

Abstract

To investigate the effect of low-doses esketamine on spinal anesthesia-induced hypotension in women with preoperative anxiety undergoing elective cesarean section, the randomized controlled trial enrolled 120 women aged 18-35 years who preoperative State-Trait Anxiety Inventory State scores > 40, conducted from September 2022 to August 2023 in Xuzhou Central Hospital, China. Women in the esketamine group received a single intravenous injection of 0.2 mg/kg esketamine after sensory block level achieved. The incidence of hypotension in the esketamine group was significantly lower than the control group at T2 (10% [6 of 60]; P < 0.001), T3 (5.0% [3 of 60]; P = 0.007) and T4(5.0% [3 of 60]; P = 0.004). Despite being higher in the esketamine group, the overall rates of hypertension (11.7% [7 of 60]; P = 0.186), tachycardia (23.3% [14 of 60]; P = 0.246), and bradycardia (0.0% [0 of 60]; P = 0.079) were no significantly difference between the two groups. STAI-S scores was significantly lower in the esketamine group (mean [SD] 37.52[7.14]) than in the control group (mean [SD] 41.03[9.66], P = 0.39) in postoperative day 1. Spinal anesthesia combined with intravenous low-doses esketamine infusion can significantly reduce the incidence of hypotension in women with preoperative anxiety undergoing elective cesarean section.

Keywords

Humans, Female, Ketamine, Cesarean Section, Adult, Hypotension, Anxiety, Double-Blind Method, Pregnancy, Anesthesia, Spinal, Elective Surgical Procedures, Adolescent, Young Adult, Preoperative Period, China

Comments

PMID: 39048628