November 2026

Lab Vision We explore mechanisms whereby anesthetics lead to amnesia, hypnosis (i.e. impaired behavioral responsiveness), immobility, and analgesia. We develop pharmacologic and device-based methods to modulate components of anesthesia non-invasively.

AY '26-'27 Goals → November Goals

• Submit a manuscript for publication
  • Methohexital data sharing agreement or IRB
  • Ketamine systematic review with Grace/Brian

• Submit RISE 1 application
  • Read CLASS-D papers from Christian
  • Start mining the CLASS-D dataset
  • Talk to Emma about process of getting IRB approval for a study

• Identify additional funding sources and apply
• Start recruiting a research team
  • Lab website
  • Update faculty profile
  • Timeline for matching MD/PhD students

Weekly Summaries

November 5

• Took the day off.
• Teasing out the appropriate interpretation of behavioral screening assays for C. elegans. How do you differentiate if a drug effect is analgesic, paralytic, sedative/hypnotic, or amnestic?
  • Can they be paralyzed with rocuronium? Would it be fatal?
  • Do worms sleep? When? How long? How do you know? What are several ways you might wake them up?
  • What are some learning/memory assays in worms that don't require movement?
  • Paralyze the worms and then see if you can teach them something (e.g. to associate a sound or light with an aversive stimulus)
  • Repeat the experiment with propofol, which we know decreases locomotion.

November 11

• Outline submission guidelines for IJOA (15 minutes)
• Flu shot (15 minutes)
• Demo Respiration.AI hardware (1 hr)... Hgb mass loss. IRB approval to NOT use the Neptune. Analyze PACU and volunteer dataset (ataxic breathing, whatever else).
• SCD-PV systematic review, IRB stuff (1 hr)
• Ketamine systematic review (2.5 hr)... HADS-D, SDS, PHQ-9, HAMD, BDI
• Lab website (1 hr)
• Read CLASS-D papers (1 hr)
• Open and briefly explore CLASS-D data (1 hr) -> 8 hrs total

Ketamine Review

Postoperative Depression

Ovid MEDLINE(R) ALL <1946 to November 10, 2026>

1. (HAM-D or Hamilton Depression Rating Scale or HDRS or Hamilton Rating Scale for Depression or Beck Depression Inventory or BDI or PHQ-9 or HADS-D or HADS or "Hospital Anxiety and Depression Scale" or Zung Self-Rating Depression Scale or Zung Self Rating Depression Scale or Self Rating Depression Scale or Self-Rating Depression Scale).mp. or Depressive Disorder/ or Mood Disorders/ or Major Depressive Disorder/ or Depression/ (n=340793)
2. Perioperative Period/ or Operating Rooms/ or General Surgery/ or Postoperative Complications/ or (postoperative or post operative or post-operative or operating room or intraoperative or intra operative or intra-operative).mp. (n=1392167)
3. Ketamine/ or esketamine.mp. (n=18740)
4. 1 and 2 and 3 (n=107)

Summary: 14 of these were review articles. Between 2022 and now, 9 systematic reviews were done w/wo meta analysis, most of them showing a beneficial and sustained effect of ketamine with minimal side effects aside from dizziness and dissociation.

Caption text

Year	First Author	Journal	Study Type	Population	Intervention	Comparator	Outcome
2026	He	J of Investigative Surgery	double-blind RCT	132 adult patients undergoing lap radical resection for CRC	Intraoperative bolus at induction of 0.5 mg/kg ketamine plus an infusion of 1 mg/kg added to PCIA post-op	Placebo	Improved HADS-D on POD 1 and 3.
2026	Chen	Annals of Medicine	double-blind RCT	84 adult patients getting acoustic neuroma surgery	0.2 mg/kg/hr continuous infusion of ketamine followed by 1 mg/kg PCIA post-op.	placebo	Esketamine significantly reduced the incidence of depression (HADS-D >7) at POD1 (7.7% versus 31.6%; relative risk 0.24, 95% CI: 0.08-0.80, p = 0.008) and POD3 (0.0% versus 15.8%, relative risk 0.00, 95% CI: 0.00-0.47, p = 0.031)
2026	Liu	BMC Psychiatry	double-blind RCT	120 adult patients scheduled for breast cancer surgery	0.2 mg/kg at induction, followed by a continuous infusion of 0.1 mg/kg/hr	placebo	At POD30, the ketamine group achieved a significantly greater reduction in PHQ-9 scores compared to the control group, with an adjusted mean difference of 0.96 points (95% CI 0.42-1.51, P < 0.01)
2026	Tan	BMC Anesthesiology	RCT	53 adult patients with PD	0.25 mg/kg ketamine at induction followed by 0.125 mg/kg/hr continuous infusion	placebo	SDS scores at POD 1, 3, and 7 were lower in the ketamine group.
2025	He	Psycho-Oncology	RCT	230 adult patients with mild-to-moderate depressive symptoms undergoing abdominal tumor resection	0.4 mg/kg ketamine at induction	placebo	On POD1 the ketamine group had a slightly higher treatment response (OR 1.4), and a mean decrease in PHQ-9 of 1, but it was not sustained at day 3 or 7.
2025	Zhang	Pharmacological Research	multi-center, double-blind RCT	132 cardiac valve surgery patients	0.3 mg/kg single dose ketamine at induction	placebo	HADS scores were significantly lower at POD7 in the ketamine group with rates of depression of 7% vs 31% in placebo.
2025	Luo	Actas Espanolas de Psiquiatria	RCT	280 patients who underwent elective caesarean section under spinal anaesthesia	single intravenous injection of esketamine at a dose of 0.25 mg/kg (diluted to 5 mL and administered intravenously within 10 min after foetus removal)	placebo	Primary outcome was EPDS score on PPD3. The patients with an extroverted-stable personality in the esketamine group had a lower PPD incidence than those in the control group (11.90% vs. 25.70%, p < 0.05). No statistical difference in overall PPD incidence was observed between the two groups (35.7% vs. 29.3%, p > 0.05), suggesting a possible treatment modifying effect of personality type.
2025	Wang	BMC Geriatrics	double-blind RCT	200 patients undergoing laparoscopic abdominal surgery aged 60 years or older	0.3 mg/kg/h starting 10 min before the induction of anesthesia and continuing until the end of the surgical procedure	placebo	HADS-D score was significantly lower on POD1 and 3 (visually estimated from figure to be 10 vs. 11 and 7 vs 8 respectively).
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Postpartum Depression

Ovid MEDLINE(R) ALL <1946 to November 10, 2026>

1. (HAM-D or Hamilton Depression Rating Scale or HDRS or Hamilton Rating Scale for Depression or EPDS or Edinburgh Postnatal Depression Scale or Beck Depression Inventory or BDI or PHQ-9 or HADS-D or HADS or "Hospital Anxiety and Depression Scale" or Zung Self-Rating Depression Scale or Zung Self Rating Depression Scale or Self Rating Depression Scale or Self-Rating Depression Scale or Baby Blues).mp. or Depressive Disorder/ or Mood Disorders/ or Major Depressive Disorder/ or Depression/ or Depression, Postpartum/ (n=349125)
2. Ketamine/ or esketamine.mp. (n=18740)
3. (Caesarean Section or Caesarean Delivery or Cesarean Section or Cesarean Delivery or Parturient).mp. or Pregnancy/ or Cesarean Section/ or Anesthesia, Obstetrical/ or Delivery, Obstetric/ or Obstetric Labor Complications/ or Postpartum Period/ (n=1113875)
4. 1 and 2 and 3 (n=78)
5. limit 4 to "review articles" (n=7)

Summary: of the 7 review articles, 5 were systematic reviews and meta analyses. All favored ketamine for the reduction of PPD, but low-quality of evidence and medication side effects were frequently mentioned.