Trial reportDrug design, development and therapy2025
The Effect of Opioid-Free Anesthesia with Esketamine on Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Thoracoscopic Surgery: A Prospective, Randomized, Controlled Trial.
Trial report in Drug design, development and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 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
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Efficacy of opioid-free versus opioid-inclusive anesthesia on postoperative nausea, vomiting, and quality of recovery in patients undergoing video-assisted thoracoscopic surgery: a systematic review and meta-analysis.BMC anesthesiology · 2026Pooled it
- 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
- Effects of oliceridine-based patient-controlled intravenous administration on postoperative pain and hemodynamic stability in elderly patients undergoing laparoscopic surgery for colorectal cancer.American journal of cancer research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Postoperative cognitive dysfunction (POCD) occurs at a higher rate in elderly patients undergoing thoracoscopic surgery, significantly affecting postoperative recovery and quality of life. However, effective interventions and anesthesia-related risk factors remain poorly understood. Purpose: This study aimed to evaluate the impact of esketamine-based opioid-free anesthesia (OFA) on POCD in elderly patients undergoing thoracoscopic lung cancer surgery. Patients and Methods: In this study, 80 elderly patients undergoing thoracoscopic lung cancer surgery were randomly allocated to receive either opioid-free anesthesia with esketamine (OFA group) or opioid-based anesthesia (Control group). The primary outcome was the incidence of POCD within 3 days. Logistic regression was used to identify risk factors for POCD. Results: The incidence of POCD was 20% and 42.5%, respectively, in the OFA group and the Control group (risk ratio [RR], 0.47; 95% confidence interval [CI], 0.24 to 0.92; risk difference [RD], -22.5%; 95% CI, -44.8% to -0.2%; p = 0.054). Compared to the Control group, patients in the OFA group had lower simple reaction time at 1 and 3 days post-surgery (1-day: p = 0.031; 3-day: p = 0.020). In addition, patients in the OFA group demonstrated higher mean values for mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI), stroke volume (SV), and systemic vascular resistance index (SVRI), as well as smaller variation ranges for these parameters, compared to the Control group (all p < 0.05), Furthermore, age (OR, 2.738; 95% CI, 1.37 to 6.30; p = 0.008), CO range (OR, 4.673; 95% CI, 2.25 to 11.82; p < 0.001), and time to first analgesic request (OR, 0.399; 95% CI, 0.18 to 0.76; p = 0.01) were validated to correlate with POCD. Conclusion: Esketamine-based OFA did not significantly reduce POCD incidence, and it was associated with improved postoperative reaction time and reduced intraoperative hemodynamic fluctuations.
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