Molecular Psychiatry
January 20, 2023
Jie Guo, Di Qiu, Han-Wen Gu et al.
46 citations
Perioperative intravenous ketamine reduces postoperative depression scores and pain scores on the first day after surgery but increases the risk of adverse effects including nausea, vomiting, headache, hallucination, and dizziness. The analysis of 15 randomized controlled trials with 1697 patients receiving ketamine and 1462 controls showed a reduction in depression scores on postoperative days 1, 3, and 7 and over the long term. Pain scores were lower only on the first postoperative day. The authors conclude that ketamine's benefits for postoperative depression and pain must be weighed against its increased adverse effects.
Molecular neurobiology
May 23, 2025
Hui Bai, Shan Du, Di Qiu et al.
4 citations
Repeated or prolonged ketamine exposure can damage the developing hippocampus and impair cognitive function. This study in rats and cell lines shows that the enzyme GPX4 protects against this damage. Inhibiting GPX4 with RSL3 worsened lipid peroxidation, mitochondrial damage, and cell death via the NLRP3/caspase-1 pathway, leading to greater hippocampal injury and cognitive deficits. The antioxidant N-acetylcysteine (NAC) reversed these effects. The findings suggest that GPX4 normally suppresses pyroptosis, and boosting its expression may be a strategy to prevent ketamine-induced neurotoxicity in the developing brain.
Molecular neurobiology
March 20, 2025
Hui Bai, Hui Chen, Shan Du et al.
4 citations
Ketamine, a common anesthetic for children, can harm the developing brain by triggering two forms of cell death: ferroptosis and pyroptosis. In experiments on newborn rats and cultured nerve cells, giving N-acetylcysteine (NAC) beforehand reduced damage. NAC lowered harmful lipid oxidation and mitochondrial injury, blocked pyroptosis driven by the NLRP3/caspase-1 pathway, and lessened hippocampal tissue damage and later cognitive problems. The results indicate that reactive oxygen species (ROS) are central to ketamine's developmental neurotoxicity, and NAC protects the brain by inhibiting ROS-driven ferroptosis and pyroptosis.
Translational psychiatry
November 24, 2025
Xin-Yu Li, Di Qiu, Ni Du et al.
1 citation
Patients with preexisting sleep disorders are at higher risk for postoperative sleep disturbance (PSD). In a randomized trial of 130 patients, intraoperative esketamine (0.3 mg/kg/h) reduced the incidence of PSD on postoperative day 1 (43.1% vs. 64.6%; odds ratio, 0.414) and lowered hydromorphone use. Preoperative oral microbiota profiles differed between patients who later developed PSD and those who did not, with specific bacterial taxa linked to sleep disturbance. The findings suggest esketamine may help prevent postoperative sleep disruption, possibly by modulating the oral microbiota.