Esketamine and neurocognitive disorders in adult surgical patients: a meta-analysis DOI Creative Commons
Lin Xing, Xin Liu, H. Huang

et al.

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: Dec. 5, 2024

Prior meta-analyses have established the potential of intravenous ketamine in safeguarding against neurocognitive impairment, but efficacy esketamine for prevention perioperative disorders (PND) remains uncertain. The primary aim this meta-analysis was to conduct a comprehensive evaluation effects on PND adult surgical patients undergoing general anesthesia. We searched several electronic databases and clinical trial registries find relevant trials. Randomized controlled trials use adjuvant were included analysis. main outcome measured risk postoperative delirium(POD) cognitive dysfunction (POCD). Secondary outcomes assessment status, pain scores (VAS/NRS), remifentanil consumption occurrence nausea vomiting (PONV). Thirteen studies encompassing procedures such as abdominal, thoracoscopic lung, gastrointestinal, laparoscopic gynecological, spinal surgery, modified radical mastectomy, A cohort comprising 1068 underwent anesthesia, with 584 assigned group 484 designated placebo group. administration anesthesia augmented by infusion esketamine, comparative analysis conducted relation alternative pharmacological interventions or placebo. application during period observed decrease POD ( RR 0.46; 95% CI: 0.32, 0.66, p < 0.0001, GRADE = High) exhibited protective influence POCD (RR 0.50; 95%CI: 0.30, 0.84, 0.009, I2 0%, Moderate). Significant improvements at 4, 24 48 h post-surgery when comparing (4 h: SMD -0.78, -1.24, -0.32, 0.0009, 58%, Low; -0.92, -1.40, -0.44, 0.0002, 86%, -0.9, -1.68, -0.12, 0.02, 89%, Low), intraoperative significantly reduced (SMD -0.56; − 0.86, 0.27, 62%, moderate). notable reduction PONV group(RR 0.64; 0.49, 0.001, High). an may represent potentially beneficial strategy reducing susceptibility PND, benefits preventing POCD. Furthermore, it can opioid alleviate intensity without increasing incidence PONV. This registered PROSPERO (CRD42023453714).

Language: Английский

Advances in the study of mechanisms underlying olfactory dysfunction in obstructive sleep apnea:a narrative review DOI Creative Commons
Qihang Zhang, Guangling Zhang,

Pengfei Ba

et al.

Sleep and Biological Rhythms, Journal Year: 2025, Volume and Issue: unknown

Published: April 3, 2025

Language: Английский

Citations

0
Esketamine and neurocognitive disorders in adult surgical patients: a meta-analysis DOI Creative Commons
Lin Xing, Xin Liu, H. Huang

et al.

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: Dec. 5, 2024

Prior meta-analyses have established the potential of intravenous ketamine in safeguarding against neurocognitive impairment, but efficacy esketamine for prevention perioperative disorders (PND) remains uncertain. The primary aim this meta-analysis was to conduct a comprehensive evaluation effects on PND adult surgical patients undergoing general anesthesia. We searched several electronic databases and clinical trial registries find relevant trials. Randomized controlled trials use adjuvant were included analysis. main outcome measured risk postoperative delirium(POD) cognitive dysfunction (POCD). Secondary outcomes assessment status, pain scores (VAS/NRS), remifentanil consumption occurrence nausea vomiting (PONV). Thirteen studies encompassing procedures such as abdominal, thoracoscopic lung, gastrointestinal, laparoscopic gynecological, spinal surgery, modified radical mastectomy, A cohort comprising 1068 underwent anesthesia, with 584 assigned group 484 designated placebo group. administration anesthesia augmented by infusion esketamine, comparative analysis conducted relation alternative pharmacological interventions or placebo. application during period observed decrease POD ( RR 0.46; 95% CI: 0.32, 0.66, p < 0.0001, GRADE = High) exhibited protective influence POCD (RR 0.50; 95%CI: 0.30, 0.84, 0.009, I2 0%, Moderate). Significant improvements at 4, 24 48 h post-surgery when comparing (4 h: SMD -0.78, -1.24, -0.32, 0.0009, 58%, Low; -0.92, -1.40, -0.44, 0.0002, 86%, -0.9, -1.68, -0.12, 0.02, 89%, Low), intraoperative significantly reduced (SMD -0.56; − 0.86, 0.27, 62%, moderate). notable reduction PONV group(RR 0.64; 0.49, 0.001, High). an may represent potentially beneficial strategy reducing susceptibility PND, benefits preventing POCD. Furthermore, it can opioid alleviate intensity without increasing incidence PONV. This registered PROSPERO (CRD42023453714).

Language: Английский

Citations

1