Trial reportDrug design, development and therapy2026
Bolus versus Continuous Infusion of Esketamine for Prevention of Postpartum Depression After Caesarean Delivery: A Randomized, Double-Blind, Controlled Trial.
Trial report in Drug design, development and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
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Abstract
Background: Esketamine is increasingly being applied for preventing postpartum depression (PPD). However, clinical protocols for this application are inconsistent, particularly concerning the route of administration. The aim was to determine whether esketamine bolus administration differed from continuous infusion in terms of preventing PPD. Methods: A total of 503 subjects without prenatal depression undergoing caesarean delivery were included in this superiority trial and randomly allocated to three groups: the esketamine bolus group received a bolus injection of 0.25 mg/kg esketamine, the esketamine infusion group was administered a continuous infusion of 0.25 mg/kg esketamine, while the control group was given an equivalent volume of normal saline. Primary outcome was set as the incidence of PPD at 6 weeks postpartum. The positive screening of PPD was defined as Edinburgh Postnatal Depression Scale (EPDS) with scores of more than 10. Incidence of PPD at 1 and 4 weeks postpartum, pain scores and all adverse events were also assessed. Results: Esketamine bolus administration significantly reduced the incidence of PPD compared with control group (9.15% vs 19.33%; RR 0.47, 95% CI 0.25-0.91). However, no statistically significant difference was observed between the bolus group and the infusion group (9.15% vs 11.54%; RR 0.79, 95% CI 0.40-1.57). There were no significant differences in PPD incidence at 1 and 4 weeks postpartum among the three groups. Similarly, the analgesic effects were comparable across the three groups. Regarding adverse events, less dizziness and nausea/vomiting during surgery was revealed with esketamine bolus administration. Overall, subjects receiving esketamine bolus administration also experienced fewer intraoperative adverse events than those in the infusion group (45.75% vs 65.38%, RR 0.73, 95% CI 0.56-0.95). Conclusion: For patients without prenatal depression undergoing caesarean delivery, esketamine bolus administration or continuous infusion demonstrated comparable efficacy for preventing PPD, bolus administration may be the preferred route due to a lower incidence of adverse events.
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