SynthesisFrontiers in medicine2026
Perioperative dexmedetomidine plus esketamine for postoperative neurocognitive outcomes: a systematic review and meta-analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Abstract
Background: Perioperative neurocognitive disorders (PND), including postoperative cognitive dysfunction (POCD) and postoperative delirium (POD), are common complications after surgery and are associated with poor clinical outcomes. This systematic review and meta-analysis aimed to evaluate the effects of perioperative combined administration of dexmedetomidine and esketamine on postoperative neurocognitive function and perioperative recovery outcomes. Methods: PubMed, Embase, Web of Science, Cochrane Library, CNKI, and the Chinese Medical Journal Full-text Database were systematically searched from database inception to April 2026. Randomized controlled trials and prospective cohort studies evaluating perioperative dexmedetomidine combined with esketamine were included. The primary outcomes were postoperative neuronal injury biomarkers and cognitive function scores. Secondary outcomes included postoperative delirium, postoperative nausea and vomiting (PONV), and postoperative pain scores. Meta-analysis was performed using RevMan and Stata software, and evidence quality was assessed using the GRADE approach. Results: Eight studies involving 1,118 patients were included, comprising seven randomized controlled trials and one prospective cohort study. Compared with controls, combined dexmedetomidine and esketamine was associated with lower postoperative 24-h serum neuron-specific enolase (NSE) levels (SMD = -0.95, 95% CI: -1.16 to -0.73, Conclusion: The findings suggest that perioperative combined administration of dexmedetomidine and esketamine may be associated with attenuated postoperative neuronal injury, improved early cognitive function, and reduced risks of POD, PONV, and pain. Further high-quality multicenter randomized controlled trials are warranted to confirm these preliminary findings.
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