Bolus versus Continuous Infusion of Esketamine for Prevention of Postpartum Depression After Caesarean Delivery: A Randomized, Double-Blind, Controlled Trial.
Drug design, development and therapy January 1, 2026 Jie Yang, Qiqi Yan, Ting Zhang et al.
Among women without prenatal depression who delivered by caesarean section, a single bolus injection of 0.25 mg/kg esketamine reduced the rate of postpartum depression (PPD) at six weeks to 9.15%, compared with 19.33% in the saline placebo group. Continuous infusion of the same dose produced a PPD rate of 11.54%, which did not differ statistically from the bolus group. Pain scores were similar across all three groups. The bolus route caused fewer intraoperative adverse events—45.75% versus 65.38% with infusion—especially less dizziness and nausea or vomiting. For preventing PPD, bolus and continuous infusion appear equally effective, but bolus administration may be preferable because it is better tolerated.