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Intravenous patient-directed analgesia with Esketamine, combined with pulsed radiofrequency, may mitigate pain and improve early signs of anxiety and depression in postherpetic neuralgia, suggesting a holistic approach to pain management.
While both Esketamine and Sufentanil administered via patient-controlled analgesia (PICA) have proven equally effective in easing pain for individuals suffering from postherpetic neuralgia (PHN), the use of Esketamine also shows promise in alleviating early symptoms of anxiety and depression, as deciphered from the findings of a retrospective observational study.
PHN can leave patients not only grappling with pain but also battling depressive symptoms, negatively impacting their quality of life. While Esketamine has garnered attention for its pain-relieving abilities, its rapid effects on mood warrant further investigation. This study digs deep into the potential of intravenous PICA with Esketamine to enhance emotional well-being in PHN sufferers.
Conducted at the affiliated hospital of Southwest Medical University, this retrospective analysis focused on hospitalized PHN patients who were split into two groups:
Pulsed radiofrequency treatment was administered to the targeted nerve root directed by ultrasound imaging. Either Sufentanil or Esketamine was infused intravenously at 1 ml/hour via a pump, with PICA set at 0.5 ml per demand and a 30-minute lockout, utilized consistently for about three days. The levels of pain (via numerical rating scale, NRS), depression (via the Patient Health Questionnaire-9, PHQ-9), and anxiety (via Generalized Anxiety Disorder-7, GAD-7) were evaluated at different time intervals (3 days, 7 days, 1 month, 2 months and 3 months) after the use of Esketamine or Sufentanil.
Key Findings of Analysis:
Eighty-three patients were analyzed. No significant differences in pain, depression, or anxiety scores between the two groups were observed initially. Particularly, both treatments led to noteworthy reductions in pain NRS scores across all time points (P < 0.05), with no differences between the groups. However, group E reported lower depression scores than group S at 3 and 7 days after treatment, though these differences faded by 1 month. In the case of anxiety levels, more significant differences were found in group E at 3 and 7 days but, were analogous in both groups thereafter.
BMC Psychiatry
Intravenous patient-controlled analgesia with Esketamine improves early depressive symptoms in patients with postherpetic neuralgia: a single-center retrospective cohort study
Ling Qiu et al.
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