Effects Of Single Subanesthetic Dose Of Ketamine On Postoperative Depression Levels In Breast Cancer Patients With Preoperative Depression

Objective:We observed the effects of a single subanesthetic dosage of ketamine on postoperative depression levels in breast cancer patient who had been experienced depressed mood before undergoing modified radical mastectomy.Methods:Fifty cases for confine modified radical mastectomy of breast cancer, with the scores of 17-item Hamilton depression scale(HAMD) ≥15, were enrolled and randomly divided into 2 groups: and control group, 25 patients in each group. One hour after the routine induction of general anesthesia, ketamine of 0.5mg/kg were infused with micro-pump to patients in ketamine group while the same amount of normal saline were infused to patients in control group, both were finieshed within 10 minutes. At 1 day before surgery and the 1th, 3th, 7th day after surgery, all patients were treated with HAMD for depression score, and Social Support Research Scale(SSRS) for social support at 1 day preoperatively and 7 day postoperatively, Visual Analogue Scale/Score(VAS) for pain at 1, 3, 7 day postoperatively were also applied.The time of operation and extubation, the use of vasoactive agents, the adverse reactions in recovery and postoperative period were also recorded simultaneously.Results:1. SSRS scores before operation and 7 day after operation were no significant difference between the two groups(P>0.05). VAS scores at 1, 3, 7 day postoperatively were also no significant difference between the two groups(P>0.05).2. There was no significant statistical difference for operation time and the use of vasoactive agents between two groups(P>0.05).3. HAMD scores before operation had no significant difference between two groups(P>0.05); While the scores at 1, 3 day postoperatively in ketamine group were lower than that in control group, and the difference was statistically significant(P<0.05). It meaned that the use of ketamine during operation can significantlyimprove the postoperative symptoms for breast cancer patients with preoperative depression. Although HAMD scores in ketamine group at 7 day postoperatively still lower than that in control group, the difference was no statistically significant(P>0.05).HAMD scores at 1 day preoperatively and 1 day postoperatively had no significant difference in control group(P>0.05); Although HAMD scores at 3 and 7day postoperatively were both lower than that at 1 day preoperatively, the difference was still no statistically significant(P>0.05). However, HAMD scores at 1, 3, 7day postoperatively in ketamine group were all significant lower than that before operation(P<0.05).4. There was no significant statistical difference for extubation time(P>0.05).There was no significant statistical difference for the adverse reactions in recovery and postoperative period between two groups(P>0.05).Conclusion:Under the condition of our study, a single subanesthetic dosage of ketamine administered during operation can significantly improve the postoperative symptoms for breast cancer patients with preoperative depression.