Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients.
Lang Wang, Baoxin Ma, Jianping Zhang
Open medicine (Warsaw, Poland) January 1, 2025 DOI: 10.1515/med-2025-1193 via PubMed
Summary
AI-generated from the abstractElderly ischemic stroke patients who received a subclinical dose of esketamine (0.25 mg/kg) during neurointerventional procedures under general anesthesia showed higher scores on the Mini-Mental State Examination (MMSE) 24 hours after surgery, indicating less early cognitive dysfunction, compared to those who did not receive esketamine. The esketamine group also had lower serum levels of NLRP3, interleukin-17, and interleukin-6. Statistical analysis linked NLRP3 levels to cognitive outcomes. Heart rate, mean arterial pressure, preoperative NLRP3, IL-6, IL-17, and esketamine treatment were identified as risk factors for cognitive dysfunction. Subclinical esketamine may reduce postoperative cognitive dysfunction risk and offer neuroprotection.
Study at a glance
| Characteristics | Prospective cohort study Peer reviewed |
|---|---|
| Sample size | 120 |
| Population | Elderly ischemic stroke patients undergoing general anesthesia for neurointerventional procedures |
| Intervention | Esketamine |
| Dose | 0.25 mg/kg |
| Topics | Esketamine |
| Keywords | Neuroprotection Mmse Nlrp3 Cognitive dysfunction |
| Citations | 1 |
| Key finding | Subclinical doses of esketamine were associated with higher MMSE scores and lower serum NLRP3, IL-17, and IL-6 levels 24 hours postoperatively in elderly ischemic stroke patients. |
Abstract
This study investigates the effects of subclinical doses of esketamine on serum NLRP3 levels and early cognitive dysfunction in elderly ischemic stroke patients after neurointerventional procedures under general anesthesia. A prospective cohort study included 120 elderly ischemic stroke patients undergoing general anesthesia from January 2022 to September 2023. The esketamine group received 0.25 mg/kg of esketamine. Serum levels of NLRP3, C-reactive protein, interleukin-6 (IL-6), IL-1β, and IL-17 were measured before surgery and 24 h postoperatively. Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE). At 24 h postoperatively, the esketamine group had significantly higher MMSE scores (p < 0.05) and lower serum levels of NLRP3, IL-17, and IL-6. Pearson's correlation showed a link between NLRP3 levels and cognitive outcomes. Logistic regression identified heart rate, mean arterial pressure, preoperative NLRP3, IL-6, IL-17, and esketamine treatment as risk factors for cognitive dysfunction. Subclinical doses of esketamine might reduce postoperative cognitive dysfunction risk and offer neuroprotection, presenting potential therapeutic options for elderly ischemic stroke patients.