Evidence map›Paper›PMID 38849859›Full record

ArticleJournal of cardiothoracic surgery2024

The influence of low-dose s-ketamine on postoperative delirium and cognitive function in older adults undergoing thoracic surgery.

Yujia Wang, Bingqiang Ma, Chaochang Wang, Yingqi Wang, Aijia Liu, Lihua Hang

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PubMed Full text at PMC Publisher
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Article in Journal of cardiothoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yujia WangDepartment of Anesthesiology, Kunshan First People's Hospital, Kunshan Hospital Affiliated to Jiangsu University, No.566 Qianjin East Road, Kunshan, 215300, China. yujiawang2023@126.com.
Bingqiang MaDepartment of Anesthesiology, Kunshan First People's Hospital, Kunshan Hospital Affiliated to Jiangsu University, No.566 Qianjin East Road, Kunshan, 215300, China.
Chaochang WangDepartment of Anesthesiology, Kunshan First People's Hospital, Kunshan Hospital Affiliated to Jiangsu University, No.566 Qianjin East Road, Kunshan, 215300, China.
Yingqi WangDepartment of Anesthesiology, Kunshan First People's Hospital, Kunshan Hospital Affiliated to Jiangsu University, No.566 Qianjin East Road, Kunshan, 215300, China.
Aijia LiuDepartment of Anesthesiology, Kunshan First People's Hospital, Kunshan Hospital Affiliated to Jiangsu University, No.566 Qianjin East Road, Kunshan, 215300, China.
Lihua HangDepartment of Anesthesiology, Kunshan First People's Hospital, Kunshan Hospital Affiliated to Jiangsu University, No.566 Qianjin East Road, Kunshan, 215300, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative delirium (POD) and cognitive dysfunction (POCD) are common complications following thoracic surgery, particularly in patients aged 65 years and above. These complications can significantly affect recovery and increase healthcare costs. This study investigates the effects of low-dose S-ketamine on reducing POD and POCD in this patient demographic.

methodsIn this retrospective cohort study, medical records of patients aged ≥ 65 years who underwent elective thoracic surgery from January 2019 to August 2023 were reviewed. Patients were categorized into S-ketamine and Control groups based on intraoperative S-ketamine exposure. POD was assessed using the Confusion Assessment Method (CAM), while cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) at baseline, 1 week, 1 month, and 6 months post-surgery. Intraoperative and postoperative parameters, including hemodynamic stability, blood loss, pain scores, and ICU stay length, were also recorded.

resultsThe study comprised 140 participants, with 70 in each group. The S-ketamine group demonstrated a significantly lower incidence of POD at 7 days post-surgery (12.0% vs. 26.7%, P < 0.001), and reduced POCD at 1 month (18.7% vs. 36.0%, P < 0.05) and 6 months (10.7% vs. 21.3%, P < 0.05). The Ketamine group had a significantly higher median MoCA score compared to the Control group both at 1 month (P = 0.021) and 6 months (P = 0.007). Adverse events, such as infection, bleeding, and respiratory failure, showed no significant differences between the groups, suggesting a safe profile for S-ketamine.

conclusionAdministering low-dose S-ketamine during thoracic surgery in patients aged 65 years and above significantly reduces the incidence of POD and POCD, highlighting its neuroprotective potential. These findings advocate for the inclusion of S-ketamine in anesthetic protocols to improve postoperative outcomes and reduce healthcare costs in this patient population.

Indexed as

DeliriumKetaminePostoperative ComplicationsThoracic Surgical ProceduresAgedAged, 80 and overCognitionCognitive DysfunctionFemaleHumansMaleRetrospective StudiesEsketamineKetamineCognitive dysfunctionNeuroprotectionOlder patientsPostoperative deliriumSafety ProfileS-ketamineThoracic surgery

Identifiers

PMID38849859
PMCPMC11157807

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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.