使用预防性氯胺酮缓解术后抑郁症状:系统回顾

IF 1.6 4区 医学 Q2 NURSING Journal of Perianesthesia Nursing Pub Date : 2024-10-03 DOI:10.1016/j.jopan.2024.05.026
Eleanor Yip, Desiree Fleck
{"title":"使用预防性氯胺酮缓解术后抑郁症状:系统回顾","authors":"Eleanor Yip, Desiree Fleck","doi":"10.1016/j.jopan.2024.05.026","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Depression is predicted to be the leading burden of disease worldwide by 2030 with a prevalence of 10% to 60% in the surgical population. Depressive symptoms in the perioperative population are associated with a myriad of grave complications, including higher morbidity and mortality. This systematic review aims to determine whether a single dose of intravenous ketamine can be used prophylactically as a routine resilience-enhancing agent in all high-risk adult patients undergoing surgery to mitigate depressive symptoms postoperatively by appraising evidence of existing literature.</p><p><strong>Design: </strong>An evidence-based systematic review.</p><p><strong>Methods: </strong>The databases PubMed, CINAHL, and Scopus were searched, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Search and Medical Subject Headings (MeSH) terms used: \"ketamine,\" \"surgical procedures,\" \"surgical,\" \"surgery,\" \"depression,\" and \"depressive disorder.\"</p><p><strong>Findings: </strong>In 9 randomized controlled trials (RCTs), bolus ketamine doses of 0.1 mg/kg to 1 mg/kg were administered intraoperatively or in the postanesthesia care unit. The primary outcome was the subjective feelings of depression as evaluated by different validated depression screening tools and seven RCTs observed statistically significant findings between the control and intervention (ketamine) groups with postoperative depression scores. Two RCTs did not find a significant change in depression scores.</p><p><strong>Conclusions: </strong>Research on the use of prophylactic ketamine as an antidepressant in the perioperative population offers insight into changing routine practices and can shape how mental health is viewed in hospitals. Further research is warranted on the safety profile of ketamine, and risk stratification with careful consideration of baseline depressive symptoms, timing, and its use across a wider variety of surgical subspecialties.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Use of Prophylactic Ketamine to Mitigate Postoperative Depressive Symptoms: A Systematic Review.\",\"authors\":\"Eleanor Yip, Desiree Fleck\",\"doi\":\"10.1016/j.jopan.2024.05.026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Depression is predicted to be the leading burden of disease worldwide by 2030 with a prevalence of 10% to 60% in the surgical population. Depressive symptoms in the perioperative population are associated with a myriad of grave complications, including higher morbidity and mortality. This systematic review aims to determine whether a single dose of intravenous ketamine can be used prophylactically as a routine resilience-enhancing agent in all high-risk adult patients undergoing surgery to mitigate depressive symptoms postoperatively by appraising evidence of existing literature.</p><p><strong>Design: </strong>An evidence-based systematic review.</p><p><strong>Methods: </strong>The databases PubMed, CINAHL, and Scopus were searched, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Search and Medical Subject Headings (MeSH) terms used: \\\"ketamine,\\\" \\\"surgical procedures,\\\" \\\"surgical,\\\" \\\"surgery,\\\" \\\"depression,\\\" and \\\"depressive disorder.\\\"</p><p><strong>Findings: </strong>In 9 randomized controlled trials (RCTs), bolus ketamine doses of 0.1 mg/kg to 1 mg/kg were administered intraoperatively or in the postanesthesia care unit. The primary outcome was the subjective feelings of depression as evaluated by different validated depression screening tools and seven RCTs observed statistically significant findings between the control and intervention (ketamine) groups with postoperative depression scores. Two RCTs did not find a significant change in depression scores.</p><p><strong>Conclusions: </strong>Research on the use of prophylactic ketamine as an antidepressant in the perioperative population offers insight into changing routine practices and can shape how mental health is viewed in hospitals. Further research is warranted on the safety profile of ketamine, and risk stratification with careful consideration of baseline depressive symptoms, timing, and its use across a wider variety of surgical subspecialties.</p>\",\"PeriodicalId\":49028,\"journal\":{\"name\":\"Journal of Perianesthesia Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Perianesthesia Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jopan.2024.05.026\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perianesthesia Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jopan.2024.05.026","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0

摘要

目的:据预测,到 2030 年,抑郁症将成为全球主要的疾病负担,在手术人群中的发病率为 10%至 60%。围手术期人群中的抑郁症状与多种严重并发症有关,包括发病率和死亡率较高。本系统性综述旨在通过对现有文献证据的评估,确定是否可将单剂量静脉注射氯胺酮作为一种常规抗抑郁药,预防性地用于所有接受手术的高风险成人患者,以减轻术后抑郁症状:设计:基于证据的系统综述:方法:根据《系统综述和元分析首选报告项目》指南,对PubMed、CINAHL和Scopus数据库进行检索。使用的检索词和医学主题词(MeSH)包括"氯胺酮"、"外科手术"、"外科"、"手术"、"抑郁症 "和 "抑郁障碍":在9项随机对照试验(RCT)中,术中或麻醉后护理病房中使用的氯胺酮剂量为0.1毫克/千克至1毫克/千克。七项研究发现,对照组和干预组(氯胺酮)的术后抑郁评分在统计学上有显著差异。有两项研究发现抑郁评分没有明显变化:关于在围手术期人群中使用氯胺酮作为抗抑郁药的研究为改变常规做法提供了启示,并能影响医院对心理健康的看法。关于氯胺酮的安全性、风险分层、基线抑郁症状、使用时机以及在更广泛的外科亚专科中使用氯胺酮的问题还需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
The Use of Prophylactic Ketamine to Mitigate Postoperative Depressive Symptoms: A Systematic Review.

Purpose: Depression is predicted to be the leading burden of disease worldwide by 2030 with a prevalence of 10% to 60% in the surgical population. Depressive symptoms in the perioperative population are associated with a myriad of grave complications, including higher morbidity and mortality. This systematic review aims to determine whether a single dose of intravenous ketamine can be used prophylactically as a routine resilience-enhancing agent in all high-risk adult patients undergoing surgery to mitigate depressive symptoms postoperatively by appraising evidence of existing literature.

Design: An evidence-based systematic review.

Methods: The databases PubMed, CINAHL, and Scopus were searched, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Search and Medical Subject Headings (MeSH) terms used: "ketamine," "surgical procedures," "surgical," "surgery," "depression," and "depressive disorder."

Findings: In 9 randomized controlled trials (RCTs), bolus ketamine doses of 0.1 mg/kg to 1 mg/kg were administered intraoperatively or in the postanesthesia care unit. The primary outcome was the subjective feelings of depression as evaluated by different validated depression screening tools and seven RCTs observed statistically significant findings between the control and intervention (ketamine) groups with postoperative depression scores. Two RCTs did not find a significant change in depression scores.

Conclusions: Research on the use of prophylactic ketamine as an antidepressant in the perioperative population offers insight into changing routine practices and can shape how mental health is viewed in hospitals. Further research is warranted on the safety profile of ketamine, and risk stratification with careful consideration of baseline depressive symptoms, timing, and its use across a wider variety of surgical subspecialties.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.20
自引率
17.60%
发文量
279
审稿时长
90 days
期刊介绍: The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.
期刊最新文献
Evaluation of Postanesthesia Handoff Checklist on Patient Outcomes in an Adult Postanesthesia Care Unit. Determination of Compassion Satisfaction and Compassion Fatigue Among Surgical Nurses. Nebulized Dexmedetomidine for Sedation and Mask Acceptance in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Effects of Auricular Acupressure on Postoperative Nausea and Vomiting in Patients With Gynecological Laparoscopic Surgery: A Randomized Controlled Trial. Noise in the Postanesthesia Care Unit: Identifying Potential Causes for Increased Noise Levels.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1