SynthesisBMC geriatrics2026
Perioperative esketamine-containing strategies and postoperative neurocognitive outcomes in older surgical patients: a systematic review and meta-analysis of randomized controlled trials with certainty assessment.
Synthesis in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative delirium (POD) is a common neurocognitive complication after surgery in older adults and is associated with adverse clinical outcomes. Esketamine, the S-enantiomer of ketamine and an N-methyl-D-aspartate (NMDA) receptor antagonist with established analgesic effects and potential anti-inflammatory properties, may therefore influence postoperative neurocognitive outcomes. However, the efficacy of ketamine-containing perioperative strategies for preventing POD remains uncertain.
methodsThis systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement and registered in PROSPERO (CRD420261370159). Randomized controlled trials evaluating perioperative esketamine in adults aged ≥ 60 years undergoing surgery were included. The primary outcome was POD incidence. Secondary outcomes included postoperative cognitive dysfunction or delayed neurocognitive recovery, postoperative nausea and vomiting, and psychiatric adverse events. Random-effects models, subgroup analyses, exploratory exposure-response analyses, and GRADE certainty assessments were performed.
resultsSeventeen randomized controlled trials involving 2,914 participants were included, with eleven trials contributing to the primary POD analysis. Esketamine-containing perioperative regimens were associated with reduced POD incidence compared with control interventions (OR = 0.57, 95% CI 0.40-0.82; P = 0.002; I
conclusionsPerioperative esketamine may be associated with reduced POD incidence in older surgical patients; however, given heterogeneity in perioperative management and limited certainty of evidence, these findings should be interpreted cautiously and require confirmation in future standardized trials.
trial registrationPROSPERO CRD: 420261370159. Retrospectively registered.
Indexed as
Identifiers
What OpenQuestion holds
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.