Intraoperative Low-dose S-ketamine Reduces Depressive Symptoms in Patients with Crohn’s Disease Undergoing Bowel Resection: A Randomized Controlled Trial

Abstract

Abstract Purpose We aim to investigate the effect of S-ketamine preconditioning on postoperative depression in patients with CD undergoing bowel resection with mild to moderate depression and to observe whether it can relieve postoperative pain and anti-inflammation. Methods A total of 120 adult patients were randomised in to one of the two groups; Patients in the S-ketamine group received 0.25mg/kg S-ketamine intravenous drip under general anesthesia induction, followed by continuous infusion of S-ketamine with 0.12mg/kg/h for more than 30 minutes through target-controlled infusion. Patients in the placebo group received 0.9% saline. The patients in both groups were evaluated by depression scale, pain scale and inflammatory factors at set intervals during a total period of one month starting from the end of operation. Results There was no significant difference in preoperative age, sex, body mass index (BMI), PHQ-9, and HAMD-17 scores between the two groups (P > 0.05). The scores of PHQ-9 and HAMD-17 in the S-ketamine group were lower than those in the placebo group on the 1st, 3rd, and 7th day postoperatively (P < 0.05). There was no significant difference in PHQ-9 and HAMD-17 scores between the two groups one month postoperatively (P > 0.05). The NRS scores of PACU, 1 day and 2 days postoperatively in the S-ketamine group were lower than those in the placebo group (P < 0.05). There was no significant difference in NRS score between the two groups at 7 days postoperatively (P > 0.05). There was no significant difference in postoperative complications, hospital stay, CRP, and IL-6 levels on the 1st and 3rd day postoperatively between the two groups (P > 0.05). Conclusion In patients with Crohn’s disease undergoing bowel resection with mild to moderate depression, intraoperative infusion of low-dose S-ketamine was effective in relieving depression one week after surgery and reducing postoperative pain two-day.