Preoperative Ketamine and Perioperative Depression
Randomised, double‑blind, parallel pilot study (n=40 planned) comparing a single preoperative IV ketamine infusion (0.5 mg/kg over 40 min) versus midazolam (0.045 mg/kg) to improve perioperative depressive symptoms in surgical patients with a history of MDD.
Details
This trial tests the feasibility and preliminary efficacy of a single preoperative sub‑anesthetic ketamine infusion (0.5 mg/kg IV over 40 minutes) compared with midazolam (0.045 mg/kg IV) given 1–3 days before surgery to reduce depressive symptoms in patients with a history of major depressive disorder.
Primary aims are feasibility of enrolment, estimate of variability in change in MADRS score at day 1 post‑surgery (≥2‑point improvement), and safety/tolerability including dysphoric reactions and need for hospitalization.
Population: adults with life history of MDD undergoing lumbar surgery; cognitive status screened with MMSE; outcomes include MADRS change, adverse events, and perioperative complications.