Single low-dose esketamine improves postpartum depression symptoms and recovery quality in cesarean section women.

To investigate the effects of single low-dose esketamine combined with patient-controlled intravenous analgesia (PCIA) on early postpartum depression symptoms and recovery quality in women undergoing cesarean section. This prospective, randomized, controlled study enrolled 136 women scheduled for elective cesarean section, who were randomly assigned in a 1:1 ratio to the study group (esketamine group, n=68) or the control group (placebo group, n=68). In the study group, esketamine (0.2 mg/kg) was intravenously infused for 40 minutes immediately after fetal delivery. In the control group, an equal volume of normal saline was given. Both groups then received PCIA for pain relief maintenance after the operation. The Edinburgh Postnatal Depression Scale (EPDS) scores, Obstetric Quality of Recovery-10 (ObsQoR-10) scores, and postoperative recovery indicators were compared between groups at different time points after surgery. Compared with the control group, the study group showed significantly lower EPDS scores at postoperative days 2 and 7, higher ObsQoR-10 scores, shorter times to first ambulation, flatus, and breastfeeding, as well as increased breastfeeding frequency within 48 hours (all P<0.05). The incidence of adverse reactions revealed no statistically significant difference (P>0.05). A single low-dose esketamine combined with PCIA effectively alleviates early postpartum depression symptoms, enhances postoperative recovery in women undergoing cesarean section, and demonstrates good safety and clinical applicability.