Evidence map›Paper›PMID 39609668›Full record

SynthesisBMC anesthesiology2024

Effect of esketamine on postoperative delirium in general anesthesia patients undergoing elective surgery: a meta-analysis of randomized controlled trials.

Wenhui Zhang, Di Wang, Siru Li, Yutao Chen, Congjie Bi

2 registry-linked trialsAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06817239 narecruitingnot on this mapstarted 2025, after this paper: background citation

Effect of Perioperative Low-dose EsketaMine on dElirium in High-risk Elderly Patients uNdergoing elecTive Major Non-cardiac Surgery: a Multi-center Randomized Trial (ELEMENT Trial)

TypeinterventionalSponsorNanfang Hospital, Southern Medical UniversityRan2025 to 2027Enrolled1,670ConditionsDelirium in Old Age, Delirium, Postoperative, Anesthesia, Cognitive DysfunctionArmsEsketamine, Normal saline
NCT07736092 narecruitingnot on this mapstarted 2026, after this paper: background citation

Impact of Perioperative Transcranial Photobiomodulation on Delayed Neurocognitive Recovery in Older Patients After Surgery: a Randomized, Double-blind, Pseudo-modulation-controlled Preliminary Clinical Trial

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2027Enrolled130ConditionsOlder Adults, Surgery, Transcranial Photobiomodulation, Delayed Neurocognitive RecoveryArmsTranscranial photobiomodulation therapy, Transcranial pseudo-photobiomodulation
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
  4. Trial
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  6. Risk factors for delirium after hip arthroplasty: An umbrella meta-analysis.International journal of nursing studies advances · 2026
    Review
  7. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Wenhui ZhangDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, No. 826 Southwest Road, Shahekou District, Dalian, Liaoning Province, China.
Di WangDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, No. 826 Southwest Road, Shahekou District, Dalian, Liaoning Province, China.
Siru LiDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, No. 826 Southwest Road, Shahekou District, Dalian, Liaoning Province, China.
Yutao ChenDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, No. 826 Southwest Road, Shahekou District, Dalian, Liaoning Province, China.
Congjie BiDepartment of Anesthesiology, Central Hospital of Dalian University of Technology, No. 826 Southwest Road, Shahekou District, Dalian, Liaoning Province, China. bcj0411@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative delirium is a common neurological complication, especially in older patients undergoing surgery, which is closely related to the poor prognosis of patients. The objective was to investigate the effects of esketamine on postoperative delirium in patients with general anesthesia.

methodsThe databases of PubMed, Embase, Cochrane Library and the Chinese National Knowledge Infrastructure were searched for all available randomised controlled trials on the effects of esketamine induction on postoperative delirium in patients undergoing elective general anesthesia from inception until April 21, 2024. We used RevMan5.4 software for data analysis. Dichotomous data was analyzed by risk ratios(RR) with a 95% confidence interval(CI), and continuous data by mean differences(MD). We also evaluated the risk of literature bias using the Cochrane Bias Risk Assessment tool.

resultsWe included a total of 17 randomized controlled trials, including 1286 patients undergoing elective general anesthesia. In 17 studies, esketamine significantly reduced the incidence of postoperative delirium (RR: 0.43; 95%CI: 0.33 ~ 0.57; p < 0.001). Five studies examined the incidence of postoperative adverse events (nausea, vomiting, dizziness and resporatory depression) and showed no statistically significant difference between the esketamine group and the control group (normal saline or dexmedetomidine) (RR: 0.82; 95%CI: 0.65 ~ 1.03; p = 0.08). In addition, this study found that the esketamine group had a lower incidence of hypotension (RR: 0.24; 95%CI: 0.12 ~ 0.48; p < 0.001) and a lower score on the visual analogue scale 24 h after surgery (MD: -0.44; 95%CI: -0.54 ~ -0.33; p < 0.001).

conclusionAccording to our meta-analysis, the use of esketamine during anesthesia induction significantly reduced the incidence of postoperative delirium in patients undergoing elective general anesthesia without increasing the incidence of postoperative adverse reactions.

Indexed as

Anesthesia, GeneralElective Surgical ProceduresKetamineRandomized Controlled Trials as TopicDeliriumEmergence DeliriumHumansPostoperative ComplicationsEsketamineKetamineCognitive dysfunctionDelayed neurocognitive recoveryDeliriumEsketamineGeneral anesthesiaNeuropsychological testsOlder patientsPostoperative cognitive complicationsPostoperative deliriumSurgery

Identifiers

PMID39609668
PMCPMC11603621

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.