The effects of prophylactic use of esketamine on postoperative depression and quality of life: a meta-analysis.

Prophylactic esketamine given before or during surgery reduces postoperative depressive symptoms and the incidence of depression, anxiety, and chronic pain, while improving sleep quality and overall quality of life. A meta-analysis of 11 randomized controlled trials involving 1447 participants found that esketamine lowered depressive symptoms (standardized mean difference -0.61) and cut the risk of postoperative depression by 63% (relative risk 0.37). The evidence suggests that using esketamine preventively during the perioperative period offers significant benefits for patients' mental health and recovery.

Study at a glance

Abstract

The aim of this systemic review and meta-analysis was to assess the impact of prophylactic use of esketamine on postoperative depression and quality of life in patients. We searched for all articles on esketamine in patients after surgury in electronic data bases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, up to the June 2023.The included studies compared the impact of using esketamine and placebo on postoperative depression and quality of life in patients through randomized controlled trials. The outcome measurements consist of postoperative depression and indicators that can reflect the impact on patients' post Cochrane Risk of Bias tool in Review Manager 5.4 tool was adopted to assess the risk of bias. The study included a total of 11 randomized controlled trials with 1447 participants. This meta-analysis demonstrated that the prophylactic use of esketamine alleviated postoperative depressive symptoms (standardized mean difference [SMD]: -0.61; 95% confidence interval [CI]: -0.96 to -0.25; P=0.0008) and incidence (relative risk [RR]:0.37;95% [CI]: 0.22 to 0.62; P=0.0001), reducing the occurrence of postoperative depression, anxiety, and chronic pain. Additionally, it improved postoperative sleep quality and enhanced the postoperative quality of life for patients. Prophylactic use of esketamine during the preoperative and anesthesia period has shown significant benefits in improving postoperative quality of life. It can effectively alleviate postoperative depression, anxiety, and chronic pain, as well as enhance sleep quality.