Skip to content

Effect of Low-Dose Esketamine on Postoperative Delirium in Elderly Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Controlled Trial.

Chao-Bang Ma, Cheng-Yang Zhang, Cai-Li Gou, Zeng-Hui Liang, Jing-Xian Zhang, Fei Xing, Jing-Jing Yuan, Xin Wei, Ya-Bing Zhang, Zhong-Yu Wang

Drug Design, Development and Therapy 2024 DOI: 10.2147/DDDT.S477342 (opens in new tab)

Read Full Text
Relevant Not relevant

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 260
Population Elderly patients undergoing total hip or knee arthroplasty
Intervention Esketamine
Dose 0.20 mg/kg loading, 0.125 mg/kg/h infusion, 0.5 mg/kg for postoperative analgesia
Duration Initial three postoperative days
Topics Esketamine Ketamine
Keywords Aged Delirium Pain management Elderly care Senior medicine Joint replacement arthroplasty Joint arthroplasty Hip replacement Knee replacement Anesthesia esketamine
Citations 27
Key findings Low-dose esketamine did not significantly reduce the incidence of postoperative delirium compared to placebo in elderly patients after total hip or knee arthroplasty.

Abstract

Postoperative delirium (POD) is a prevalent and severe complication in elderly patients undergoing major surgery, associated with increased morbidity and mortality. This randomized controlled trial aimed to investigate the effects of low-dose esketamine on the incidence of POD in elderly patients underwent total hip or knee arthroplasty. Two hundred and sixty elderly participants were randomly assigned to either the esketamine group (Group E) (0.20mg/kg loading, 0.125mg/kg/h infusion, 0.5 mg/kg for postoperative analgesia) or the placebo group (Group P) (received normal saline). The primary outcome was the incidence of POD, with secondary outcomes including delirium subtypes, duration, intraoperative analgesic consumption, operative and anesthesia times, hemodynamic changes, postoperative pain scores, sleep quality, and common postoperative adverse events. There was no significant difference in the incidence of POD between Group E (8.5%) and Group P (10.8%). No significant differences were observed for the time of delirium onset, duration of delirium, and delirium subtype between the two groups. Patients in the esketamine group had more stable hemodynamic profile after induction and reduced the pain score of motion on the first two days postoperatively but increased the incidence of postoperative dizziness. The repeated infusion of low-dose esketamine did not reduce the incidence of POD during the initial three postoperative days in elderly patients following total hip or knee arthroplasty.

Comparable studies

Other randomized controlled trials on esketamine, most cited first.

Study Year Design Participants
Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study Adults with moderate to severe nonpsychotic depression and a history of nonresponse to... 2019 Phase 3, double-blind, active-controlled, multicenter randomized controlled trial n = 227
Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression Adults with treatment-resistant depression who achieved stable remission or stable... 2019 Phase 3, multicenter, double-blind, randomized withdrawal study n = 297
Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression Adults with DSM-IV-TR diagnosis of major depressive disorder and history of inadequate... 2017 Phase 2, double-blind, doubly randomized, delayed-start, placebo-controlled study n = 67
Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study Depressed patients at imminent risk for suicide 2018 Randomized controlled trial n = 68
Efficacy and Safety of Fixed-Dose Esketamine Nasal Spray Combined With a New Oral Antidepressant in Treatment-Resistant Depression: Results of a Randomized, Double-Blind, Active-Controlled Study (TRANSFORM-1) Adults with moderate-to-severe depression and nonresponse to at least two... 2019 Randomized controlled trial n = 346

Citations in the library

Cited by 5

Cites 10

and 5 more in the library

Related reading

Explore topics

Esketamine Ketamine