Intraoperative Low-Dose S-Ketamine Reduces Depressive Symptoms in Patients with Crohn's Disease Undergoing Bowel Resection: A Randomized Controlled Trial

This randomized controlled trial investigated the effects of intraoperative low-dose S-ketamine on postoperative depression in patients with Crohn's disease (CD) undergoing bowel resection. 124 patients with mild-to-moderate depression were randomized into S-ketamine (0.25 mg/kg IV drip followed by 0.12 mg/kg/h infusion) or placebo groups. The primary outcome was the Hamilton Depression Scale (HAMD-17). Secondary outcomes included PHQ-9, QoR-15, NRS, CRP, IL-6 levels, hospital stay, and opioid use. S-ketamine significantly reduced HAMD-17 and PHQ-9 scores on PODs 1, 2, and 7, and improved QoR-15 scores on PODs 3 and 5, and lowered NRS scores on PACU and PODs 1 and 2. No significant differences were found in CRP, IL-6, complications, or hospital stay. Intraoperative low-dose S-ketamine alleviated depressive symptoms and postoperative pain in CD patients without compromising safety.

Z Zhang, W-H Zhang, Y-X Lu, B-X Lu, Y-B Wang, L-Y Cui, H Cheng, Z-Y Yuan, J Zhang, D-P Gao, Edward A Bittner, Zhen Zhang, Jian-Feng Gong, Qing Ji