A single intravenous dose of esketamine (0.25 mg/kg) given before anesthesia induction lowers the risk of postoperative delirium in adults undergoing on-pump cardiac valve surgery. In a randomized controlled trial of 112 patients (average age 52 years, 53.6% female), delirium occurred in 23.2% of those given esketamine versus 44.6% in the placebo group, a relative risk reduction of about half. Esketamine also reduced the number of patients with multiple delirium episodes and the hyperactive subtype. The results suggest esketamine is an effective preventive intervention for delirium in this surgical population.
A bibliometric analysis of 10,328 ketamine research articles published from 2014 to 2023 shows steady growth in publication volume. The United States and China lead in both publication and citation counts. The National Institute of Mental Health and Yale University are the most active institutions, and Carlos Zarate of the NIMH has the highest number of significant publications and co-citations. Key research themes include mechanism of action, adverse events, psychiatric applications, and perioperative implications. The analysis maps the global research landscape, identifying trends, key contributors, and thematic focus areas to guide future work on ketamine's therapeutic potential.