The effects of esketamine on postoperative delirium in older patients with fragile brain function during the non-acute phase following lung cancer surgery: a randomized controlled trial
Abstract
Esketamine has been used in the prevention of postoperative neurocognitive disorders in trauma surgery, gastrointestinal surgery and other fields due to its significant anti-inflammatory effect. However, its effect on postoperative delirium (POD) in older patients with fragile brain function after lung cancer remains unclear. This study aims to evaluate the effect of low-dose esketamine on POD in older patients with fragile brain function following lung cancer surgery during the perioperative period. One hundred and eight older patients undergoing thoracoscopic radical lung cancer surgery were randomly assigned to the control group or the esketamine group. All patients received standardized anesthesia without pre-anesthesia medication. Esketamine group received esketamine 0.25 mg/kg during anesthesia induction and esketamine 0.1 mg/kg/h during anesthesia maintenance for 30 min. Control group received an equal volume of normal saline during both induction and maintenance of anesthesia. The Confusion Assessment Method (CAM) was used to evaluate the incidence(%) of POD at 24 h and 72 h post-surgery. Serum concentration of interleukin-6 (IL-6) and calcium-binding protein β(S100β)(mean ± SD) were measured intravenously before and one day after surgery to assess inflammation. Additionally, intraoperative dosages of propofol, sufentanil, and remifentani(mean ± SD)were recorded, along with postoperative extubation time, SpO2 after extubation (mean ± SD), incidence (% ) of vertigo,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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