Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial

Abstract: Introduction: Depressive symptoms are common in elderly surgical patients and are associated with negative outcomes. Although medication can relieve symptoms, only 50% of patients achieve remission using conventional treatments. Recently, ketamine has been shown to improve depression rapidly. However, its use and tolerability in elderly patients has not been widely studied. Material and methods: We conducted a randomized, double-blind, comparative study in patients aged 60 and over who required ophthalmological surgery. Experimental group received 0.5 mg/kg ketamine, whereas the control group received NaCl solution at 0.9%. Both groups received a standardized regimen of conscious sedation. Depressive symptom severity was assessed using the Geriatric Depression Scale-Short Form (GDS-SF) before and after exposure to ketamine infusion; tolerability was also evaluated. A repeated univariate analysis of variance (ANOVA) model examined the direction of changes in depressive symptom severity among groups. Results: 90 patients were randomized. A significant reduction in symptom severity was observed after ketamine infusion (mean change from baseline: -1.6 vs -0.3 in the control group; p = 0.003). No differences emerged between groups in the presence of adverse effects with ketamine infusion. Conclusions: A single infusion of ketamine in elderly patients undergoing ophthalmological surgery is associated with improved depressive symptoms in the first 24 hours of exposure to the drug with a good tolerability profile.

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Main Authors: Rascón-Martínez,Dulce María, Fresán-Orellana,Ana, Duque-Alarcón,Xochitl, Carmona-Alvarado,Ana, Castellanos-Olivares,Antonio, Pérez-Zepeda,Mario U
Format: Digital revista
Language:English
Published: Colegio Mexicano de Anestesiología A.C. 2022
Online Access:http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0484-79032022000400231
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spelling oai:scielo:S0484-790320220004002312023-02-01Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trialRascón-Martínez,Dulce MaríaFresán-Orellana,AnaDuque-Alarcón,XochitlCarmona-Alvarado,AnaCastellanos-Olivares,AntonioPérez-Zepeda,Mario U Depressive symptoms ketamine infusion elderly patients Abstract: Introduction: Depressive symptoms are common in elderly surgical patients and are associated with negative outcomes. Although medication can relieve symptoms, only 50% of patients achieve remission using conventional treatments. Recently, ketamine has been shown to improve depression rapidly. However, its use and tolerability in elderly patients has not been widely studied. Material and methods: We conducted a randomized, double-blind, comparative study in patients aged 60 and over who required ophthalmological surgery. Experimental group received 0.5 mg/kg ketamine, whereas the control group received NaCl solution at 0.9%. Both groups received a standardized regimen of conscious sedation. Depressive symptom severity was assessed using the Geriatric Depression Scale-Short Form (GDS-SF) before and after exposure to ketamine infusion; tolerability was also evaluated. A repeated univariate analysis of variance (ANOVA) model examined the direction of changes in depressive symptom severity among groups. Results: 90 patients were randomized. A significant reduction in symptom severity was observed after ketamine infusion (mean change from baseline: -1.6 vs -0.3 in the control group; p = 0.003). No differences emerged between groups in the presence of adverse effects with ketamine infusion. Conclusions: A single infusion of ketamine in elderly patients undergoing ophthalmological surgery is associated with improved depressive symptoms in the first 24 hours of exposure to the drug with a good tolerability profile.info:eu-repo/semantics/openAccessColegio Mexicano de Anestesiología A.C.Revista mexicana de anestesiología v.45 n.4 20222022-12-01info:eu-repo/semantics/articletext/htmlhttp://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0484-79032022000400231en10.35366/106341
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country México
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author Rascón-Martínez,Dulce María
Fresán-Orellana,Ana
Duque-Alarcón,Xochitl
Carmona-Alvarado,Ana
Castellanos-Olivares,Antonio
Pérez-Zepeda,Mario U
spellingShingle Rascón-Martínez,Dulce María
Fresán-Orellana,Ana
Duque-Alarcón,Xochitl
Carmona-Alvarado,Ana
Castellanos-Olivares,Antonio
Pérez-Zepeda,Mario U
Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
author_facet Rascón-Martínez,Dulce María
Fresán-Orellana,Ana
Duque-Alarcón,Xochitl
Carmona-Alvarado,Ana
Castellanos-Olivares,Antonio
Pérez-Zepeda,Mario U
author_sort Rascón-Martínez,Dulce María
title Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
title_short Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
title_full Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
title_fullStr Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
title_full_unstemmed Effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
title_sort effect of single infusion of ketamine on depressive symptoms in elderly patients undergoing ophthalmological surgery: a randomized controlled trial
description Abstract: Introduction: Depressive symptoms are common in elderly surgical patients and are associated with negative outcomes. Although medication can relieve symptoms, only 50% of patients achieve remission using conventional treatments. Recently, ketamine has been shown to improve depression rapidly. However, its use and tolerability in elderly patients has not been widely studied. Material and methods: We conducted a randomized, double-blind, comparative study in patients aged 60 and over who required ophthalmological surgery. Experimental group received 0.5 mg/kg ketamine, whereas the control group received NaCl solution at 0.9%. Both groups received a standardized regimen of conscious sedation. Depressive symptom severity was assessed using the Geriatric Depression Scale-Short Form (GDS-SF) before and after exposure to ketamine infusion; tolerability was also evaluated. A repeated univariate analysis of variance (ANOVA) model examined the direction of changes in depressive symptom severity among groups. Results: 90 patients were randomized. A significant reduction in symptom severity was observed after ketamine infusion (mean change from baseline: -1.6 vs -0.3 in the control group; p = 0.003). No differences emerged between groups in the presence of adverse effects with ketamine infusion. Conclusions: A single infusion of ketamine in elderly patients undergoing ophthalmological surgery is associated with improved depressive symptoms in the first 24 hours of exposure to the drug with a good tolerability profile.
publisher Colegio Mexicano de Anestesiología A.C.
publishDate 2022
url http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0484-79032022000400231
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