Effects of Different Anesthesia Applications on Mood, Depression, and Anxiety Levels in Burn Patients.

Ketamine sedation during burn surgery may reduce postoperative depression and anxiety. In a study of 67 patients aged 18–65 with no prior mental illness, those receiving ketamine sedation had significantly lower depression scores on the Montgomery-Asberg Depression Rating Scale after surgery (11.63 ± 5.49) than before (14.44 ± 7.22). Anxiety scores decreased in both ketamine and general anesthesia groups. No patient reported suicidal ideation at any point. The findings suggest that ketamine sedation, already used for pain management, could also help prevent mood disorders in burn patients, who are at high risk for depression, anxiety, and suicidal tendencies due to their trauma.

Study at a glance

Abstract

Adequate and effective pain management and prevention of depression are essential in patients with burns. This study aims to explore the effects of ketamine sedation in patients with burns in terms of mood disorders, depression, anxiety, and suicidality during postoperative follow-up in the intensive care unit. This study targeted subjects aged 18-65 years, in the ASA I-II class, with basic communication skills, no history of diagnosed mental illness, and no history of neuropsychiatric or cognitive disorders or related treatment. The study was conducted on 67 patients. After preoxygenation, anesthesia induction was practiced with 2 mg/kg intravenous (IV) propofol and 1 mcg/kg IV fentanyl in the general anesthesia group. Anesthesia was continued with a mixture of 0.3-0.5 mcg/kg/min remifentanil, 2% sevoflurane, 50% air, and 50% oxygen. In the sedation group, 1 mcg/kg IV fentanyl and 1 mg/kg IV ketamine were administered at induction; anesthesia was maintained by adding 30-50 mg IV propofol if necessary. The Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), and Beck Scale for Suicidal Ideation (BSSI) have been administered via way of means of a psychiatrist preoperatively and on the primary postoperative day. In intragroup evaluations, MADRS values for the sedation anesthesia group decreased statistically significantly after the anesthesia (11.63 ± 5.49) compared to the preanesthesia period (14.44 ± 7.22) (P < .001). HAM-A scores of both anesthesia groups decreased statistically significantly after anesthesia. No patient was found to have suicidal ideation in all evaluations in which BSSI was used. Patients with burns may have a high potential for depression, anxiety disorders, and suicidal tendencies due to the trauma they have experienced. In these patients, sedation anesthesia with ketamine may reduce negative mood, depression, anxiety, and suicidal tendencies in the postoperative period.