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Esketamine for Prevention of Depression After Cytoreductive Surgery in Ovarian Cancer

Not Applicable
Recruiting
Conditions
Ovarian Cancer
Cytoreductive Surgery
Depressive Symptom
Interventions
Drug: placebo
Registration Number
NCT06624878
Lead Sponsor
Zhejiang Cancer Hospital
Brief Summary

The goal of this clinical trial is to learn if intraoperative administration of esketamine would prevent or mitigate postoperative depressive symptoms after cytoreductive surgery in ovarian cancer. The main questions it aims to answer are:

* Whether a single low dose of esketamine administered would reduce the postoperative depressive symptoms three days after cytoreductive surgery in ovarian cancer?

* Whether a single low dose of esketamine administered would relief the postoperative sleep disturbance, postoperative recovery? Researchers will compare the esketamine to a placebo (normal saline) to see if the esketamine works to reduce the postoperative depressive symptoms.

Participants will:

* Receive either 0.2 mg/kg esketamine or placebo infused intravenously after induction of general anesthesia.

* The preoperative Patient Health Questionnaire 9 (PHQ-9) scale was used to verify the symptoms suggestive of depression.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
568
Inclusion Criteria
  • undergoing cytoreductive surgery for ovarian cancer under general anesthesia
  • ASA physical status I-III
  • Ages 18-80 years
Exclusion Criteria
  • Patients taking anti-psychotic medications
  • Contraindications to esketamine
  • Language barrier
  • Inability to provide consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
the esketamine groupesketamine-
the placebo groupplacebo-
Primary Outcome Measures
NameTimeMethod
the incidence of postoperative depressive symptoms after cytoreductive surgery in ovarian canceron postoperative day 3

The postoperative depressive symptoms are assessed using the preoperative Patient Health Questionnaire 9 (PHQ-9) scale. The range of this scale is 0-27, and a standard threshold score of 10 or higher indicates symptoms of depression.

Secondary Outcome Measures
NameTimeMethod
the incidence of depressive symptoms in ovarian cancerBaseline (before surgery), on postoperative day 30

The PHQ-9 was also used to assess the depressive symptoms.The range of this scale is 0-27, and a standard threshold score of 10 or higher indicates symptoms of depression.

the incidence of sleep disturbance in ovarian cancerBaseline (before surgery), on postoperative day 3 and on postoperative day 30

The sleep disturbance are assessed using the Athens Insomnia Scale (AIS). The range of this scale is 0-24, and a standard threshold score of 7 or higher indicates sleep disturbance.

the incidence of anxiety in ovarian cancerBaseline (before surgery)

The anxiety symptom is assessed using the Generalized Anxiety Disorder-7 (GAD-7). The range of this scale is 0-21, and a standard threshold score of 10 or higher indicates anxiety.

the postoperative recovery of ovarian cancerBaseline (before surgery), on postoperative day 3

The postoperative recovery is assessed using the quality of recovery-15 questionnaire (QoR-15) .The QoR-15 has 15 questions. Each question is rated on a 10-point scale, ranging from 0 (none of the time or poor) to 10 (all of the time or excellent). The maximum score (best recovery) is 150.

postoperative pain score at rest and coughing painat 1, 24, 48, 72 hours after surgery

The postoperative pain at rest and during coughing are assessed by NRS score with a range of 0 to 10 (0=no pain, 10=the worst possible pain).

the lengh of postoperative ICU admissionthrough study completion, an average of 1-5 days
the time to initiation of postoperative chemotherapythrough study completion, an average of 5-20 days
the postoperative complications of ovarian cancerwithin 30 days after surgery

The complications are assessed using the Claviene-Dindo score.

the time to walk after surgerythrough study completion, an average of 2-5 days
the time to return of bowel functionthrough study completion, an average of 5-10 days
the time to readiness for dischargethrough study completion, an average of 7-15 days
morphine requirements after surgeryat 48 hours after surgery
the residual disease after cytoreductive surgeryon postoperative day 1

The residual disease is assessed using the propotion of optimal debulking.

the incidence of nausea and vomitingduring 72 hours after surgery
the incidence of postoperative hypotensionduring 72 hours after surgery
the incidence of pruritusduring 72 hours after surgery
the incidence of drowsinessduring 72 hours after surgery
the incidence of respiratory depressionduring 72 hours after surgery
the incidence of nystagmusduring 72 hours after surgery
the incidence of diplopiaduring 72 hours after surgery
the incidence of hypertoniaduring 72 hours after surgery
the incidence of daymareduring 72 hours after surgery
the incedence of neuropsychiatric symptomsduring 72 hours after surgery

The neuropsychiatric symptoms are assessed using BPRS-4. The range of this scale is 0-28, and a standard threshold score of 5 or higher indicates symptoms of neuropsychiatric symptoms.

the incidence of dissociative statesduring 72 hours after surgery

The dissociative states are assessed using the CADSS-6. The range of this scale is 0-24, and a standard threshold score of 3 or higher indicates symptoms of dissociative states.

Trial Locations

Locations (1)

Zhejiang cancer hospital

🇨🇳

Hangzhou, Zhejiang, China

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