Esketamine may provide pain relief during C-section without neonatal depression: JAMA

The study concluded with the following clinical findings:

1. Esketamine resulted in lower pain scores compared to placebo after childbirth, but the difference was not clinically significant.

2. The Ramsay sedation scores were higher with esketamine than with placebo.

3. There was no significant difference in neonatal Apgar scores between the two groups.

4. Transient neurologic or mental symptoms were more common with esketamine than with placebo.

The study concluded that indications and the optimal dose of esketamine in this patient population need further clarification, but the study should be limited to those who require supplemental analgesia.

Dr. Li-Li Xu, the lead author of the study added that “Epidural anesthesia is a primary choice for cesarean delivery, but supplemental analgesics are often required to relieve pain during uterine traction. This new research could provide an alternative option for pain management during cesarean delivery, especially for patients who require supplemental analgesia.”

Reference:

Xu L, Wang C, Deng C, et al. Efficacy and Safety of Esketamine for Supplemental Analgesia During Elective Cesarean Delivery: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(4):e239321.

doi:10.1001/jamanetworkopen.2023.932