[
  {
    "id": "T004",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Coadministration group (propofol + ketamine)",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": null,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Mix of propofol 9.8 mg/mL + ketamine 0.98 mg/mL: 1-3 mL IV before local anesthetic (~1-3 mg ketamine; weight not given), then infusion of the mix at 0.3-0.5 mL/kg/min as printed (implausible unit; per hour would be ~0.3-0.5 mg/kg/h ketamine), titrated to OAA/S 4",
        "start": "at_induction",
        "end": "end_of_surgery"
      },
      {
        "name": "Propofol group (propofol alone)",
        "role": "control"
      }
    ],
    "anesthesia": "sedation",
    "conscious_dosing": "some",
    "late_dosing": null,
    "setting": "surgery",
    "procedure": "elective ambulatory surgery under monitored anesthesia care",
    "depression_selection": "unselected",
    "selection_criterion": "",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "VAS mood state 'depressed/elated' (one of six bipolar mood VAS)",
        "code": "OTHER",
        "days": [
          0
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "100-mm VAS pain in PACU",
        "code": "other",
        "days": [
          0
        ],
        "primary": false
      },
      {
        "measure": "Intraoperative fentanyl and PACU morphine doses",
        "code": "opioid",
        "days": [
          0
        ],
        "primary": false
      },
      {
        "measure": "5-point pain rating at rest after discharge",
        "code": "rest",
        "days": [
          1,
          2,
          3,
          4,
          5
        ],
        "primary": false
      },
      {
        "measure": "5-point pain rating during physical activity after discharge",
        "code": "movement",
        "days": [
          1,
          2,
          3,
          4,
          5
        ],
        "primary": false
      },
      {
        "measure": "Hydrocodone consumed after discharge",
        "code": "opioid",
        "days": [
          1,
          2,
          3,
          4,
          5
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": true,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": null,
    "enrollment": {
      "start": null,
      "end": null
    },
    "ethics_approval": true,
    "planned_n": null,
    "country": "USA",
    "centers": "single",
    "note": "Monitored anesthesia care: propofol±ketamine mixture given from the start of sedation (before local anesthetic) and infused through surgery at an OAA/S 4 target, so patients were conscious → some. 'at_induction' here means the start of sedation (no general anesthesia); end_of_surgery inferred from sedation maintained during surgery. Control = same propofol sedation without ketamine. Depression measure is the 'depressed/elated' mood VAS repeated in PACU (counted as OTHER). 'Double-blinded' without naming parties. 40 recruited (20/group), no planned size; ages not stated."
  },
  {
    "id": "T005",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Group A (propofol, fentanyl, ketamine)",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 1.0,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 1.0 mg/kg as an induction agent with propofol 1.5 mg/kg and fentanyl 2 µg/kg",
        "start": "at_induction",
        "end": "before_end_of_surgery"
      },
      {
        "name": "Group B (propofol, fentanyl)",
        "role": "control"
      },
      {
        "name": "Group C (non-depressed controls)",
        "role": "other",
        "dose_note": "25 non-depressed patients, not randomized to it; also induced with ketamine 1.0 mg/kg"
      }
    ],
    "anesthesia": "general",
    "conscious_dosing": "none",
    "late_dosing": false,
    "setting": "surgery",
    "procedure": "orthopedic surgery for arm or lower limb fracture",
    "depression_selection": "selected",
    "selection_criterion": "DSM-IV major depression diagnosed by psychiatrists, on antidepressants >1 year",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "Hamilton Depression Rating (HDR) score, 21 items",
        "code": "HAMD",
        "days": [
          1,
          3
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "100-mm VAS pain (every 8 h for 24 h, then daily)",
        "code": "other",
        "days": [
          0,
          1
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": true,
    "blinding": {
      "participants": null,
      "assessors": null
    },
    "registration": null,
    "enrollment": {
      "start": null,
      "end": null
    },
    "ethics_approval": true,
    "planned_n": null,
    "country": "Japan",
    "centers": "multi",
    "note": "Ketamine only as one of the induction agents for general anesthesia (isoflurane/N2O maintenance), single dose → none; last dose at induction → late false. Only the depressed patients were randomized (A vs B); Group C coded other. CAM confusion/psychosis recorded daily to day 7. Nurses assessing confusion and pain were unaware of the study's purpose; who rated the HDR and whether patients were blinded is not stated. 70 randomized + 25 controls, no planned size."
  },
  {
    "id": "T006",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Placebo group",
        "role": "control"
      },
      {
        "name": "Single S(+)-ketamine group",
        "role": "ketamine",
        "drug": "esketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.5,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 0.5 mg/kg over 3 min before incision; saline repeats during surgery",
        "start": "after_induction",
        "end": "before_end_of_surgery"
      },
      {
        "name": "Repeated S(+)-ketamine group",
        "role": "ketamine",
        "drug": "esketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.5,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "0.5 mg/kg before incision, then 0.2 mg/kg boluses every 20 min until 30 min before the end of surgery (no infusion)",
        "start": "after_induction",
        "end": "before_end_of_surgery"
      }
    ],
    "anesthesia": "general_and_regional",
    "conscious_dosing": "none",
    "late_dosing": false,
    "setting": "surgery",
    "procedure": "major abdominal surgery",
    "depression_selection": "unselected",
    "selection_criterion": "",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "Mood adjective choice after awakening (incl. 'depressed/euphoric', 'happy/sad')",
        "code": "OTHER",
        "days": [
          0
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "Patients requiring additional analgesics (diclofenac, then IV dextropropoxyphene)",
        "code": "other",
        "days": [
          0,
          1
        ],
        "primary": true
      },
      {
        "measure": "10-cm VAS pain after awakening and at 3, 6, 24 h",
        "code": "other",
        "days": [
          0,
          1
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": true,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": null,
    "enrollment": {
      "start": null,
      "end": null
    },
    "ethics_approval": true,
    "planned_n": 45,
    "country": null,
    "centers": null,
    "note": "Epidural (ropivacaine) established first, then general anesthesia induced; S(+)-ketamine first given pre-incision under GA (after induction, read from the sequence) and repeats stopped 30 min before the end of surgery → none; no dose in the last 30 min → late false. Epidural + GA coded general_and_regional; postoperative epidural ropivacaine only. Depression measure is the presence of a depressed/sad mood adjective after awakening (counted as OTHER). Primary outcome from the power calculation = patients needing additional analgesics. Country and number of centers not stated."
  },
  {
    "id": "T011",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "K group",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.5,
        "infusion_mg_per_kg_h": 0.25,
        "infusion_hours": 0.5,
        "pump": false,
        "dose_note": "0.5 mg/kg in the induction sequence, 20 s after midazolam 40 µg/kg and before sufentanil/propofol; then 0.25 mg/kg/h for 30 min",
        "start": "at_induction",
        "end": "before_end_of_surgery"
      },
      {
        "name": "C group (0.9% saline)",
        "role": "control"
      }
    ],
    "anesthesia": "general",
    "conscious_dosing": "none",
    "late_dosing": false,
    "setting": "surgery",
    "procedure": "orthopedic surgery for femoral and tibial fractures",
    "depression_selection": "unselected",
    "selection_criterion": "",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "PHQ-9",
        "code": "PHQ9",
        "days": [
          1,
          5
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "VAS score",
        "code": "other",
        "days": [
          1,
          5
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": false,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": {
      "registry": "ChiCTR",
      "id": "ChicTR-OCC-14004280",
      "date": null
    },
    "enrollment": {
      "start": "2014-03",
      "end": "2014-09"
    },
    "ethics_approval": true,
    "planned_n": 120,
    "country": "China",
    "centers": "single",
    "note": "Bolus is part of the general anesthesia induction sequence (after midazolam, before sufentanil and propofol), so coded at_induction → none, though the patient may still have been awake for it; infusion ended ~30 min after induction, well before the end of fracture surgery → late false. Postoperative PCIA had no ketamine. Primary outcome (power calculation) = serum BDNF. 'Related complications' recorded, kinds not named. Registry ID as printed."
  },
  {
    "id": "T015",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Ketamine group",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.25,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 0.25 mg/kg in 10 mL saline, slow IV within 5 min after umbilical cord clamping",
        "start": "after_delivery",
        "end": "before_end_of_surgery"
      },
      {
        "name": "Saline group",
        "role": "control"
      }
    ],
    "anesthesia": "neuraxial",
    "conscious_dosing": "some",
    "late_dosing": null,
    "setting": "cesarean",
    "procedure": "elective cesarean delivery under spinal anesthesia",
    "depression_selection": "unselected",
    "selection_criterion": "",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "EPDS",
        "code": "EPDS",
        "days": [
          3,
          42
        ],
        "primary": true
      }
    ],
    "pain_measures": [
      {
        "measure": "NRS pain intensity",
        "code": "other",
        "days": [
          3,
          42
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": true,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": {
      "registry": "ChiCTR",
      "id": "ChiCTR-IPR-15007159",
      "date": null
    },
    "enrollment": {
      "start": "2015-10-08",
      "end": "2016-03-10"
    },
    "ethics_approval": true,
    "planned_n": 330,
    "country": "China",
    "centers": "single",
    "note": "Single dose after cord clamping under spinal anesthesia with no general anesthesia, so the mother was awake → some. PCIA sufentanil only. Hallucination, dizziness, drowsiness, diplopia asked at 5 and 15 min after dosing."
  },
  {
    "id": "T017",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Group K (ketamine + 2 mL saline)",
        "role": "other",
        "dose_note": "Ketamine 0.5 mg/kg without dexamethasone; differs from the dexamethasone control by more than ketamine"
      },
      {
        "name": "Group D (dexamethasone + 2 mL saline)",
        "role": "control"
      },
      {
        "name": "Group KD (ketamine + dexamethasone)",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.5,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 0.5 mg/kg with dexamethasone 0.1 mg/kg (max 8 mg), 5 min after induction",
        "start": "after_induction",
        "end": "before_end_of_surgery"
      }
    ],
    "anesthesia": "general",
    "conscious_dosing": "none",
    "late_dosing": false,
    "setting": "surgery",
    "procedure": "laparoscopic gynecologic surgery",
    "depression_selection": "unselected",
    "selection_criterion": "",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "PHQ-9",
        "code": "PHQ9",
        "days": [
          1,
          3
        ],
        "primary": true
      }
    ],
    "pain_measures": [
      {
        "measure": "100-mm VAS pain at 1, 6, 24, 48 h",
        "code": "other",
        "days": [
          0,
          1,
          2
        ],
        "primary": false
      },
      {
        "measure": "PCA consumption (morphine/ketorolac) over 24 h",
        "code": "opioid",
        "days": [
          1
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": false,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": {
      "registry": "ClinicalTrials.gov",
      "id": "NCT03194594",
      "date": null
    },
    "enrollment": {
      "start": "2017-08",
      "end": "2018-01"
    },
    "ethics_approval": true,
    "planned_n": 297,
    "country": null,
    "centers": "single",
    "note": "No saline-only arm. Group D got dexamethasone plus 2 mL saline in place of ketamine, so D vs KD is ketamine vs placebo on a shared dexamethasone background: KD = ketamine, D = control. Group K (ketamine alone, no dexamethasone) differs from D by more than ketamine → other. Single dose 5 min after induction of general anesthesia → none; dose at the start of laparoscopic surgery (duration not stated) → late false. 'Side effects of the study drugs' recorded, kinds not named. Country not stated ('University Hospital')."
  },
  {
    "id": "T019",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Ketamine",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.4,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 0.4 mg/kg (ideal body weight) over 20 min in PACU, typically 45-60 min after arrival",
        "start": "after_emergence",
        "end": "after_emergence"
      },
      {
        "name": "Placebo (0.9% saline)",
        "role": "control"
      }
    ],
    "anesthesia": "general",
    "conscious_dosing": "some",
    "late_dosing": null,
    "setting": "surgery",
    "procedure": "laparoscopic gastric bypass or sleeve gastrectomy",
    "depression_selection": "unselected",
    "selection_criterion": "",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "Beck Depression Inventory (BDI)",
        "code": "BDI",
        "days": [
          1,
          2,
          7
        ],
        "primary": false
      },
      {
        "measure": "Montgomery-Asberg Depression Rating Scale (MADRS)",
        "code": "MADRS",
        "days": [
          1,
          2,
          7
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "VAS pain (0-10)",
        "code": "other",
        "days": [
          0,
          1,
          2,
          7
        ],
        "primary": true
      },
      {
        "measure": "Short-form McGill Pain Questionnaire",
        "code": "other",
        "days": [
          0,
          1,
          2,
          7
        ],
        "primary": false
      },
      {
        "measure": "Opioid use throughout hospital stay (IV morphine equivalents)",
        "code": "opioid",
        "days": [],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": false,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": {
      "registry": "ClinicalTrials.gov",
      "id": "NCT02452060",
      "date": null
    },
    "enrollment": {
      "start": null,
      "end": null
    },
    "ethics_approval": true,
    "planned_n": 100,
    "country": "USA",
    "centers": "single",
    "note": "Single postoperative dose in PACU after emergence from general anesthesia, patient awake → some. PCA hydromorphone only. No psychotomimetic or adverse-event recording described."
  },
  {
    "id": "T025",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Ketamine group",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.5,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "0.5 mg/kg infused over 40 min starting at dural opening",
        "start": "after_induction",
        "end": "before_end_of_surgery"
      },
      {
        "name": "Placebo group (normal saline)",
        "role": "control"
      }
    ],
    "anesthesia": "general",
    "conscious_dosing": "none",
    "late_dosing": false,
    "setting": "surgery",
    "procedure": "elective supratentorial brain tumor resection",
    "depression_selection": "selected",
    "selection_criterion": "Moderate-to-severe depressive symptoms: PHQ-9 >=10 and MADRS >=22 the day before surgery",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "MADRS (also at discharge)",
        "code": "MADRS",
        "days": [
          1,
          3
        ],
        "primary": true
      },
      {
        "measure": "PHQ-9 (also at discharge)",
        "code": "PHQ9",
        "days": [
          1,
          3
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "Severe pain (NRS >=5) within the first 3 postoperative days",
        "code": "other",
        "days": [
          1,
          2,
          3
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": true,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": {
      "registry": "ClinicalTrials.gov",
      "id": "NCT03086148",
      "date": null
    },
    "enrollment": {
      "start": null,
      "end": null
    },
    "ethics_approval": true,
    "planned_n": 80,
    "country": "China",
    "centers": "single",
    "note": "Ketamine 0.5 mg/kg over 40 min from dural opening under total intravenous anesthesia; it ended long before tumor resection and closure were done → none, late false. HADS used only to define anxiety, not coded as a depression measure. YMRS, BPRS (incl. hallucinations), CADSS recorded."
  },
  {
    "id": "T028",
    "eligible": true,
    "exclusion_reason": null,
    "timing_comparison": false,
    "arms": [
      {
        "name": "Control group (normal saline)",
        "role": "control"
      },
      {
        "name": "Racemic ketamine group",
        "role": "ketamine",
        "drug": "ketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.125,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 0.125 mg/kg in 2 mL after induction and intubation",
        "start": "after_induction",
        "end": "before_end_of_surgery"
      },
      {
        "name": "S-ketamine group",
        "role": "ketamine",
        "drug": "esketamine",
        "route": "iv",
        "bolus_mg_per_kg": 0.125,
        "infusion_mg_per_kg_h": null,
        "infusion_hours": null,
        "pump": false,
        "dose_note": "Single 0.125 mg/kg in 2 mL after induction and intubation",
        "start": "after_induction",
        "end": "before_end_of_surgery"
      }
    ],
    "anesthesia": "general",
    "conscious_dosing": "none",
    "late_dosing": false,
    "setting": "surgery",
    "procedure": "modified radical mastectomy for breast cancer",
    "depression_selection": "selected",
    "selection_criterion": "HAMD-17 score 8-24 before surgery",
    "age_group": "adult",
    "depression_measures": [
      {
        "measure": "HAMD-17",
        "code": "HAMD",
        "days": [
          3,
          7,
          30,
          90
        ],
        "primary": false
      }
    ],
    "pain_measures": [
      {
        "measure": "VAS pain",
        "code": "other",
        "days": [
          1,
          3,
          7
        ],
        "primary": false
      }
    ],
    "psychotomimetic_monitoring": false,
    "blinding": {
      "participants": true,
      "assessors": true
    },
    "registration": null,
    "enrollment": {
      "start": "2017-06",
      "end": "2018-06"
    },
    "ethics_approval": true,
    "planned_n": null,
    "country": "China",
    "centers": "single",
    "note": "Single dose right after induction of general anesthesia ('analgesia induction') and intubation → none; given at the start of a mastectomy → late false. Enrolled only HAMD-17 8-24 → selected. 303 enrolled, no planned size stated. Country inferred from the Chinese drug and pump makers; hospital unnamed. Postoperative complications recorded, kinds not named."
  }
]