Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients.

Abstract

<h4>Objective</h4>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.<h4>Methods</h4>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).<h4>Results</h4>At 24 h postoperatively, the esketamine group had significantly higher MMSE scores (<i>p</i> < 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.<h4>Conclusion</h4>Subclinical doses of esketamine might reduce postoperative cognitive dysfunction risk and offer neuroprotection, presenting potential therapeutic options for elderly ischemic stroke patients.

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