Small doses of esketamine given intravenously to patients with postpartum depression increased serum concentrations of the neurotransmitters 5-hydroxytryptamine (5-HT), dopamine (DA), and brain-derived neurotrophic factor (BDNF) by the third day after administration, compared to a saline placebo. Edinburgh Postnatal Depression Scale (EPDS) scores were significantly lower in the esketamine group on day 3 (12.98 vs. 16.73), but this difference was no longer present on day 30. Adverse event rates within two hours were similar between groups. The findings suggest esketamine can transiently improve postpartum depressive symptoms and alter certain neurotransmitter levels.
Adding a moderate dose of esketamine (0.03 mg/kg/h) to patient-controlled intravenous analgesia combined with a preoperative intercostal nerve block significantly reduced acute postoperative pain after thoracoscopic lobectomy, compared to a low dose of esketamine or sufentanil alone. Pain scores on the Numerical Rating Scale were lower at 2, 4, 24, 48, and 72 hours after surgery, and the need for rescue analgesia and opioid consumption decreased. The moderate esketamine group also had less postoperative nausea and vomiting than the sufentanil group. Low-dose esketamine did not improve pain control over sufentanil alone.