Determining influences of intraoperative s-ketamine on postoperative delirium and cognitive function: methodology is important.
Journal of cardiothoracic surgery December 31, 2024 Dan-Feng Wang, Fei Gao, Fu-Shan Xue
This letter raises methodological concerns about a study claiming that low-dose S-ketamine during thoracic surgery reduces postoperative delirium and cognitive dysfunction in older adults. The authors point out that the study lacked details on how often delirium was monitored each day, relied solely on the Confusion Assessment Method for screening, did not report factors contributing to delirium in the ICU, and used a non-standard definition for cognitive impairment. They note inconsistencies with a recent randomized trial and argue these issues need clarification before accepting the conclusions.