SynthesisBrain and behavior2023
Effects of anesthetic adjunctive agents on postoperative cognitive dysfunction in elderly patients undergoing noncardiac surgery: A Bayesian network meta-analysis.
Synthesis in Brain and behavior, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06774274 (Analgesic Efficacy of Intravenous Ketamine as a Continuous Infusion vs PCA in the Management of Acute Postoperative Pain in Major Orthopedic Surgery), which is not on this map. Cited by 10 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Analgesic Efficacy of Intravenous Ketamine as a Continuous Infusion vs PCA in the Management of Acute Postoperative Pain in Major Orthopedic Surgery: A Randomized Clinical Trial
Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Optimal prophylaxis for perioperative drug-induced delayed neurocognitive recovery: a Bayesian network meta-analysis of 18 interventions with mechanism-based stratification.Frontiers in pharmacology · 2026Pooled it
- Efficacy of perioperative dexmedetomidine in postoperative pain and neurocognitive functions in orthopedic surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.International journal of surgery (London, England) · 2025Pooled it
- The effect of anesthesia on postoperative cognitive dysfunction in adults undergoing cataract surgery: a systematic review.BMC anesthesiology · 2025Pooled it
- Effects of anesthetic adjunctive agents on postoperative cognitive dysfunction in elderly patients undergoing noncardiac surgery: A Bayesian network meta-analysis.Brain and behavior · 2023Pooled it
- Observational
- Comparison of Remimazolam and Propofol in Large Skull Base Tumor Resections: Effects on Hemodynamic Stability, Neurocognitive Recovery, and Inflammatory Response.Drug design, development and therapy · 2026Article
- Preventive Effect of Epigallocatechin-3-Gallate on Postoperative Cognitive Dysfunction in Aged Rats via Modulation of Microglial Differentiation: An Experimental Animal Study.International journal of molecular sciences · 2025Article
- Effect of parecoxib on postoperative cognitive function and analgesic safety in elderly patients undergoing gastrointestinal tumor resection: A retrospective study.Biomolecules & biomedicine · 2025Article
- Mechanism of cognitive impairment after laparoscopic surgery and nursing application progress based on EEG monitoring.Frontiers in neurology · 2025Review
- The influence of low-dose s-ketamine on postoperative delirium and cognitive function in older adults undergoing thoracic surgery.Journal of cardiothoracic surgery · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElderly patients are prone to postoperative cognitive dysfunction (POCD). The comparison of the effects of anesthetic adjuvant drugs on POCD in elderly patients undergoing noncardiac surgery remains controversial.
methodsThe final search took place on June 10, 2023. Randomized controlled trials including ketamine, ulinastatin, dexmedetomidine, parecoxib, and midazolam on the prevention and treatment of POCD in elderly undergoing noncardiac surgery were collected. A Bayesian network meta-analysis was performed to quantitatively combine the evidence.
resultsA total of 35 randomized trials were finally included in this systematic review, and the overall risk of bias is Allocation concealment. These anesthetic adjuvant drugs did not show significant differences in preventing POCD on postoperative days 1 and 7 compared with each other, but ulinastatin may be more effective in preventing POCD than dexmedetomidine [odds ratio (OR) = 0.28, 95% confidence interval (CI) = (0.10, 0.71)] and parecoxib [OR = 0.3, 95% CI = (0.10, 0.82 on postoperative day 3. The efficiency ranking results also find that ulinastatin and ketamine might provide better effects regarding POCD prevention.
conclusionsKetamine and ulinastatin might have better effects in preventing POCD in elderly patients undergoing noncardiac surgery. Our meta-analysis provided evidence for the use of ulinastatin and ketamine in the prevention of POCD in elderly patients undergoing noncardiac surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.