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Randomized Controlled Trial
. 2025 Aug;34(8):e70265.
doi: 10.1002/pon.70265.

The Efficacy of Sub-Anesthesia S-Ketamine on Postoperative Depressive Symptoms in Patients Undergoing Abdominal Tumor Resection: A Randomized Controlled Trial

Yi He  1 , Jiaqi Yu  2 , Jin Liu  1 , Jia Cai  3 , Zhi Li  4 , Mingzhe Xu  1 , Qian Li  1
Affiliations
Randomized Controlled Trial

The Efficacy of Sub-Anesthesia S-Ketamine on Postoperative Depressive Symptoms in Patients Undergoing Abdominal Tumor Resection: A Randomized Controlled Trial

Yi He et al. Psychooncology. 2025 Aug.

Abstract

Background: Cancer patients undergoing major surgery often have perioperative depression symptoms, and are associated with worsened outcomes.

Aims: We aimed to evaluate the efficacy of S-ketamine in alleviating depressive symptoms after abdominal Tumor surgery.

Methods: A prospective, double-blind, placebo-controlled randomized trial was conducted, enrolling 230 patients with newly screened mild-to-severe depressive symptoms scheduled for abdominal tumor resection. Participants were randomly assigned to receive either 0.4 mg/kg of S-ketamine or normal saline. The primary outcome was the difference in treatment response rates, which defined as a 50% decrease from baseline in Patient Health Questionnaire-9 (PHQ-9) on postoperative day (POD) 1. Secondary outcomes included global quality of recovery (QoR-15) scores and adverse events. Group-based trajectory modeling was used to identify the potential trajectories of depression severity over the postoperative 7-day and the risk factors were also analyzed.

Results: On POD 1, the S-ketamine group demonstrated a slightly higher treatment response (odds ratio [OR], 1.4 [95% confidence interval (CI), 0.8 to 2.6], p = 0.017), a reduction in PHQ-9 scores (MD -1.0 [95% CI, -2.0 to 0]; p = 0.002) and higher QoR-15 scores (MD -2.2 [95% CI: -4.3 to -0.7]; p = 0.043). However, the treatment responses, PHQ-9 scores and QoR-15 scores were similar on POD 3 and 7. Adverse events were comparable between the two groups. Additionally, logistic regression did not indicate significant associations between treatment allocation.

Conclusions: This study found the effects of sub-anesthesia S-ketamine on depressive symptoms in this patient population postoperatively were limited. The long-term efficacy needs to be explored.

Trial registration: Chinese Clinical Trial Registry Identifier: ChiCTR 2200065298.

Keywords: S‐ketamine; abdominal tumor resection; postoperative depressive symptoms; quality of recovery.

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References

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