January 3, 2024Open Access

The effect of esketamine on perioperative neurocognitive dysfunction in elderly patients who underwent gastrointestinal tumor surgery: a randomized double-blind controlled study

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Why the study?

It was unknown whether esketamine induction and maintenance of general anesthesia could reduce perioperative neurocognitive dysfunction in elderly patients undergoing gastrointestinal tumor surgery.

Does esketamine reduce the incidence of perioperative neurocognitive dysfunction in elderly patients undergoing gastrointestinal tumor surgery?

Population

153 elderly patients undergoing gastrointestinal tumor surgery

Comparison

Intravenous esketamine vs normal saline placebo

Design

Randomized double-blind controlled study

Follow-up

30 days

Authors

XMXiaoyan MaChangzhi Medical College WYWenli YuJiangnan University LJLili JiaTianjin First Center Hospital

Discussion

Member takes

Implication

May reduce PND risk in elderly GI surgery patients; leaves open confirmation in larger trials.

Structured PICO

Does esketamine reduce the incidence of perioperative neurocognitive dysfunction in elderly patients undergoing gastrointestinal tumor surgery?

Population

153 elderly patients (age ≥ 65 years, ASA I-III, BMI 18-30 kg/m2, NYHA I-II) undergoing gastrointestinal tumor surgery under general anesthesia. Exclusions included mental illness, severe liver/kidney dysfunction, unstable angina/MI within 3 months, preoperative blood pressure ≥180/110 mmHg, hyperthyroidism, and high intraocular pressure.

Intervention

Esketamine 0.3 mg/kg IV during anesthesia induction, followed by 0.3 mg·kg-1·h-1 IV to maintain anesthesia (stopped 1 hour before end of surgery), added to standard anesthesia.

Comparator

Equal volume of normal saline (placebo) IV during induction and maintenance, added to standard anesthesia (midazolam, propofol, sufentanil, cisatracurium, remifentanil, sevoflurane).

Outcome

Incidence of perioperative neurocognitive dysfunction (PND) within 30 days after surgery, evaluated using the Z score method from an electronic neuropsychological composite scale (MMSE, DST, CTT, SDWT, VFT).composite

In elderly patients undergoing gastrointestinal tumor surgery, esketamine induction and maintenance significantly reduced the incidence of perioperative neurocognitive dysfunction at 7 days post-surgery.

Limitations

Single-center study
Small sample size
Limited to elderly patients scheduled for gastrointestinal tumor surgery
Follow-up was not extended to 12 months and could not fully evaluate PND

Cite This Study

Ma et al. (2024) studied this question.

synapsesocial.com/papers/6a73c075cd7b40c8110dd1a6 https://doi.org/10.21203/rs.3.rs-3782664/v1

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The effect of esketamine on perioperative neurocognitive dysfunction in elderly patients who underwent gastrointestinal tumor surgery: a randomized double-blind controlled study

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

The effect of esketamine on perioperative neurocognitive dysfunction in elderly patients who underwent gastrointestinal tumor surgery: a randomized double-blind controlled study

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider