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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
568
0.2 mg/kg esketamine infused intravenously after induction of general anesthesia.
a placebo (an equivalent volume of normal saline) infused intravenously after induction of general anesthesia.
Zhejiang cancer hospital
Hangzhou, Zhejiang, China
RECRUITINGthe incidence of postoperative depressive symptoms after cytoreductive surgery in ovarian cancer
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.
Time frame: on postoperative day 3
the incidence of depressive symptoms in ovarian cancer
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.
Time frame: Baseline (before surgery), on postoperative day 30
the incidence of sleep disturbance in ovarian cancer
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.
Time frame: Baseline (before surgery), on postoperative day 3 and on postoperative day 30
the incidence of anxiety in ovarian cancer
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.
Time frame: Baseline (before surgery)
the postoperative recovery of ovarian cancer
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.
Time frame: Baseline (before surgery), on postoperative day 3
postoperative pain score at rest and coughing pain
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).
Time frame: at 1, 24, 48, 72 hours after surgery
the lengh of postoperative ICU admission
Time frame: through study completion, an average of 1-5 days
the time to initiation of postoperative chemotherapy
Time frame: through study completion, an average of 5-20 days
the postoperative complications of ovarian cancer
The complications are assessed using the Claviene-Dindo score.
Time frame: within 30 days after surgery
the time to walk after surgery
Time frame: through study completion, an average of 2-5 days
the time to return of bowel function
Time frame: through study completion, an average of 5-10 days
the time to readiness for discharge
Time frame: through study completion, an average of 7-15 days
morphine requirements after surgery
Time frame: at 24 hours after surgery
morphine requirements after surgery
Time frame: at 48 hours after surgery
the residual disease after cytoreductive surgery
The residual disease is assessed using the propotion of optimal debulking.
Time frame: on postoperative day 1
the incidence of nausea and vomiting
Time frame: during 72 hours after surgery
the incidence of postoperative hypotension
Time frame: during 72 hours after surgery
the incidence of pruritus
Time frame: during 72 hours after surgery
the incidence of drowsiness
Time frame: during 72 hours after surgery
the incidence of respiratory depression
Time frame: during 72 hours after surgery
the incidence of nystagmus
Time frame: during 72 hours after surgery
the incidence of diplopia
Time frame: during 72 hours after surgery
the incidence of hypertonia
Time frame: during 72 hours after surgery
the incidence of daymare
Time frame: during 72 hours after surgery
the incedence of neuropsychiatric symptoms
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.
Time frame: during 72 hours after surgery
the incidence of dissociative states
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.
Time frame: during 72 hours after surgery
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