In patients undergoing off-pump coronary artery bypass grafting, continuous intravenous infusion of esketamine during surgery reduced the incidence of postoperative delirium within the first seven days by about half compared with a placebo infusion of saline. Esketamine also lowered levels of the inflammatory markers interleukin-6 at 12 and 72 hours after surgery and C-reactive protein at 72 hours. The findings suggest that esketamine can decrease postoperative delirium and short-term inflammatory responses in this patient population.
A single subanesthetic dose of esketamine (30 mg/kg) alleviated PTSD-like symptoms in mice exposed to electric foot shocks. The medial prefrontal cortex showed increased numbers of Iba1-positive microglial cells and elevated pro-inflammatory cytokines (IL-6, TNF-α), indicating neuroinflammation, along with increased expression of myelin-related proteins (MBP, MAG, Olig2, PDGFRα), suggesting abnormal myelination. Esketamine treatment suppressed both the neuroinflammatory response and the aberrant myelination. The findings suggest that neuroinflammation and abnormal myelination contribute to PTSD development and highlight esketamine's therapeutic potential.