Efficacy and Safety of Esketamine for Supplemental Analgesia During Elective Cesarean Delivery

Key Points Question Is intravenous esketamine safe and effective before childbirth during cesarean delivery with epidural anesthesia? Findings In this multicenter, double-blind, randomized clinical trial of 600 women undergoing cesarean delivery with epidural anesthesia, a subanesthetic dose of esketamine administered before incision produced transient analgesia and sedation and easily passed through the placental barrier but did not induce significant neonatal depression. Mental symptoms and nystagmus were common but transient. Meaning Indications and the optimal dose of esketamine in this patient population need further clarification, but study should be limited to those who require supplemental analgesia.

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