A single low dose of esketamine given after childbirth reduces the risk of a major depressive episode at 42 days postpartum by about three quarters in mothers with prenatal depression. In a randomized trial of 364 mothers with at least mild prenatal depression, 6.7% of those receiving esketamine experienced a major depressive episode compared with 25.4% in the placebo group. Depression scores were also lower in the esketamine group at 7 and 42 days. Neuropsychiatric side effects were more common with esketamine (45.1% vs 22.0%) but were transient and resolved without drug treatment.
Median nerve stimulation combined with high gamma band activity can map the hand motor cortex during awake states, but its effectiveness declines with loss of consciousness. In five patients undergoing awake craniotomy, the sensitivity of mapping using the short-latency average envelope remained relatively stable, dropping only from 100% awake to about 82% during deeper anesthesia stages. In contrast, mapping based on average power deteriorated more sharply, from 100% awake to around 21% at the deepest stage. The long-latency average envelope also showed reduced sensitivity as consciousness declined, with a slope coefficient significantly smaller than that for short-latency responses. These results suggest that short-latency envelope-based mapping is more robust across different conscious states.