Effect of Low-Dose Esketamine on Postoperative Delirium in Elderly Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Controlled Trial.
Drug design, development and therapy January 1, 2024 Chao-Bang Ma, Cheng-Yang Zhang, Cai-Li Gou et al. 27 citations
A randomized controlled trial tested whether low-dose esketamine reduces postoperative delirium in elderly patients after total hip or knee replacement. Two hundred sixty participants received either esketamine (a loading dose of 0.20 mg/kg, infusion of 0.125 mg/kg/h, and 0.5 mg/kg for postoperative pain) or a placebo of normal saline. Delirium occurred in 8.5% of the esketamine group and 10.8% of the placebo group, a difference that was not statistically significant. The timing, duration, and subtype of delirium also did not differ between groups. Esketamine provided more stable blood pressure after anesthesia induction and lowered pain with movement during the first two days after surgery, but increased dizziness. Repeated low-dose esketamine did not reduce delirium in the first three days after surgery.