Trial reportBMC geriatrics2025
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.
Trial report in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Guideline for the Comprehensive Perioperative Management of Older Patients With Lung Cancer (2025).Journal of evidence-based medicine · 2026Guideline
- Effect of perioperative esketamine administration on the incidence of postoperative delirium: a systematic review and meta-analysis.BMC anesthesiology · 2026Pooled it
- Effects of esketamine on postoperative delirium in adult patients: a systematic review and meta-analysis of randomized controlled trials.Frontiers in neurology · 2026Pooled it
- Esketamine/Ketamine: Dual-Action Mechanisms and Clinical Prospects beyond Anesthesia in Psychiatry, Immunology, and Oncology.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Neuroinflammation in postoperative cognitive dysfunction: the multi-target potential of esketamine in modulating microglial responses and synaptic integrity.Frontiers in molecular neuroscience · 2026Review
- The esketamine-based multimodal low-opioid anaesthesia improves quality of recovery in elderly patients undergoing radical lung cancer surgery: a randomized controlled trial.Frontiers in pharmacology · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEsketamine 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.
methodsOne 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, SpO
resultsCompared with the control group, the incidence of POD was significantly lower in the esketamine group at 24 h post-operation (3.8% vs. 15.1%, P = 0.046),but no difference at 72 h post-operation (0% vs. 7.5%, P = 0.126). No significant difference in serum concentration of IL-6 and S100β was observed between the two groups on the day before surgery (P > 0.05). However, one day post-operation serum concentration of IL-6 and S100β in the esketamine group were significantly lower than those in the control group (5.14 ± 1.70 vs. 6.03 ± 2.13, P = 0.019;380.08 ± 204.01 vs. 479.32 ± 213.07, P = 0.016). The consumption of sufentanil in the esketamine group was lower than those in the control group (28.06 ± 3.76 vs. 29.85 ± 4.21, P = 0.023). Extubation time, the rate of remedial analgesia, and recovery room stay duration were shorter in the esketamine group compared to the control group(27.08 ± 8.46 vs. 30.4.±7.72, P = 0.035; 5.7% vs. 18.9%, P = 0.038; 58.96 ± 16.98 vs. 65.83 ± 15.31, P = 0.031). After extubation, SpO
conclusionEsketamine may reduce the incidence of early postoperative delirium in older patients with fragile brain function undergoing lung cancer surgery during the non-acute phase, appear to inhibit inflammation levels, and be associated with shortening postoperative recovery time.
trial registrationChictr.org.cn identifier ChiCTR2400083811 (Date of registry: 05/05/2024, prospectively registered).
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