Ketamine Pharmacokinetics and Pharmacodynamics for Postpartum Depression and Pain After Cesarean Delivery

Exclusion Criteria

• •Patient going under general anesthesia for cesarean delivery
• •Allergy to study medication (ketamine)
• •ASA PS 4 +
• •Contraindications to neuraxial anesthesia
• •Preterm delivery (\<37 weeks gestation)
• •Anticipated fetal-neonatal complex care plan as indicated in the patient's chart
• •Patient history of ketamine or PCP abuse
• •Patient history of schizophrenia or psychosis
• •Patient history of liver or renal insufficiency
• •Patient history of uncontrolled hypertension, chest pain, arrhythmia, head trauma, or intracranial hypertension, uncontrolled hyperthyroidism, or other contraindications to ketamine
• •Participating in another pain or depression intervention trial
• •Undergoing hormonal or gender affirming therapies
• •Pre-eclampsia with severe features
• •Hemodynamic instability
• •Inability to participate in study procedures for any reason
• •Contraindicated medications use: oral antihypertensive medications (exclusion: hypertensive disorders of pregnancy), intravenous magnesium (exclusion: pre-eclampsia with severe features), ketamine/phencyclidine/psilocybins/any other psychedelics (exclusion: ketamine or PCP abuse), lithium/valproate/carbamazepine/lamotrigine/haloperidol/chlorpromazine/fluphenazine/aripiprazole/clozapine/other typical or atypical antipsychotic medications (exclusion: schizophrenia or psychosis)
• •Control Participants
• •Allergy to study medication (ketamine)
• •ASA PS 4 +
• •Inability to participate in study procedures for any reason
• •Patient history of ketamine or PCP abuse
• •Patient history of schizophrenia or psychosis
• •Patient history of liver or renal insufficiency
• •Patient history of uncontrolled hypertension, chest pain, arrhythmia, head trauma, intracranial hypertension, uncontrolled hyperthyroidism, or other contraindications to ketamine
• •Participating in another pain or depression intervention trial
• •Hemodynamic instability
• •Pregnant or pregnant within the last 6 weeks
• •Unwilling to provide urine sample for pregnancy testing (female controls)
• •Undergoing hormonal or gender affirming therapies
• •Contraindicated medications use: ketamine, phencyclidine, psilocybins, or other psychedelics (exclusion: ketamine or PCP abuse), lithium/valproate/carbamazepine/lamotrigine/haloperidol/chlorpromazine/fluphenazine/aripiprazole/clozapine, or other typical or atypical antipsychotic medications (exclusion: schizophrenia or psychosis)