A single dose of 0.25 mg/kg esketamine given during breast cancer surgery did not significantly increase the proportion of women who achieved a 50% reduction in depression scores within three days after surgery. Among 104 women with preoperative depressive symptoms, 27% in the esketamine group reached this threshold versus 13% in the placebo group, a difference that was not statistically significant. However, esketamine did produce significantly lower depression scores on postoperative days one through five, with a mean additional decrease of 2.5 points on the Montgomery-Åsberg scale compared to placebo. No significant effects were seen on anxiety, pain, or adverse events.
Postoperative fatigue is common after colonoscopy, linked to bowel preparation and the procedure itself. In a randomized trial, 151 patients received either low-dose esketamine (0.15 mg/kg) or sufentanil (0.1 μg/kg) before anesthesia. Esketamine reduced the incidence of postoperative fatigue from 44% to 28% at 30 minutes after the procedure, and shortened discharge time from 30 to 25 minutes. Hemodynamic stability and patient satisfaction were also better with esketamine. The findings suggest that adding esketamine to propofol anesthesia is an effective strategy for painless colonoscopy.