ReviewAnesthesiology and perioperative science2026
A systematic review and meta-analysis on ketamine use and postoperative delirium in older patients undergoing spine or orthopedic surgery.
Review in Anesthesiology and perioperative science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between BDNF and postoperative cognitive dysfunction across surgical stages: a systematic review and meta-analysis.Frontiers in aging neuroscience · 2026Pooled it
- Advances in electroacupuncture for perioperative neurocognitive disorders: mechanisms and clinical evidence.Chinese medicine · 2026Review
- Development and multicenter validation of a dynamic nomogram for early postoperative neurocognitive disorder in older adults with hip fracture.BMC geriatrics · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Postoperative delirium (POD) is common in older adults following major surgery. Ketamine has opioid-sparing properties and potential neuroprotective effects, yet whether intraoperative ketamine reduces the incidence of postoperative delirium remains uncertain. This systematic review aims to determine whether ketamine use is associated with a lower incidence of POD in older patients undergoing spine or orthopedic surgery. Methods: We conducted comprehensive searches in PubMed, Web of Science, EMBASE, Cochrane CENTRAL, and CINAHL Complete from inception to June 26, 2025. Both keywords and index terms (Mesh/EMTREE) were used to develop broad and sensitive searches tailored to each database to retrieve all relevant articles. EMBASE results were limited to articles and articles in press. Eligible studies included patients aged ≥ 60 years undergoing surgery with intraoperative ketamine administration and reporting POD as an outcome. Two reviewers independently screened studies, extracted data, assessed risk of bias, and performed quality appraisal using RoB 2 for randomized controlled trials (RCTs) and ROBINS-I for observational studies. Random-effects meta-analyses were performed to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Results: We included 24 studies in the final analysis and five specifically studied patients undergoing spine or orthopedic surgery. The effect of ketamine on POD showed an OR of 1.50 (95% CI 0.38-5.91, Conclusions: This systematic review and meta-analysis did not find a statistically significant association between intraoperative ketamine use and POD in older patients undergoing spine or orthopedic surgery in the RCTs. However, because of the small number of available studies together with imprecision, this conclusion should only be considered as preliminary. Larger, high-quality randomized trials are needed to determine whether ketamine influences POD risk and to assess different dosing strategies for their effects on postoperative cognitive outcomes in older adults. Supplementary Information: The online version contains supplementary material available at 10.1007/s44254-025-00145-y.
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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.