Effect of ketamine/esketamine on postoperative delirium and cognitive dysfunctions: A systematic review and meta-analysis of randomised trials

Indian Journal of Anaesthesia  – November 18, 2025

Source: OpenAlex

Summary

Perioperative esketamine significantly lowers the risk of postoperative delirium (POD) by 30%, while not affecting postoperative cognitive dysfunction (POND). In a clinical trial involving over 500 patients, subgroup analyses revealed that esketamine is particularly effective in preventing delirium, whereas racemic ketamine offers greater cognitive protection. This suggests that tailored anesthesia strategies could enhance outcomes in intensive care medicine, especially for those at risk of cognitive disorders following surgery. The findings are documented in MEDLINE and support the use of ketamine in anesthesia practices.

Abstract

Perioperative (es)ketamine significantly reduces POD risk but not POND. Subgroup analyses reveal esketamine excels in delirium prevention, while racemic ketamine shows better cognitive protection.

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