A systematic review of nine randomized controlled trials examined whether a single intravenous dose of ketamine (0.1 mg/kg to 1 mg/kg) given during or shortly after surgery can prevent depressive symptoms in adults undergoing surgery. Seven of the trials found that ketamine significantly reduced postoperative depression scores compared to a control, while two trials found no significant change. Depressive symptoms affect 10% to 60% of surgical patients and are linked to higher rates of complications and death. The review suggests prophylactic ketamine may help build resilience against postoperative depression, but more research is needed on safety, timing, and use across different surgical types.
A case report describes an unusual occurrence of postoperative delirium in a patient who underwent robotic-assisted prostatectomy under an opioid-free anesthesia protocol that included intraoperative infusions of ketamine, lidocaine, and magnesium. The report details the clinical presentation, contributing factors, and management of this complication, offering educational insights for clinicians using similar multimodal analgesic strategies.