Effect of Esketamine on Postoperative Delirium and Inflammatory Response in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A Randomized Controlled Study.

Abstract

<h4>Objectives</h4>To investigate whether continuous intravenous infusion of esketamine during surgery can improve postoperative delirium (POD) and inflammatory response in patients undergoing off-pump coronary artery bypass grafting (OPCAB).<h4>Design</h4>Prospective, triple-blind, randomized controlled trial.<h4>Setting</h4>A single tertiary center.<h4>Participants</h4>140 adult patients undergoing elective OPCAB.<h4>Interventions</h4>Patients in Group S (esketamine group) received an infusion of esketamine at a dose of 0.25 mg/kg/h, while those in Group P (placebo group) received an equal volume of saline.<h4>Measurements and main results</h4>The main outcome was the incidence of POD within the first 7 days after surgery. The incidence of POD within 7 days after surgery was significantly lower in Group S compared with Group P (relative risk: 0.474, 95% confidence interval: 0.231-0.970, p = 0.034). Furthermore, the levels of interleukin-6 (IL-6) at 12th and 72nd postoperative hours were significantly lower in Group S than in Group P (Z = -2.697, p = 0.007; Z = -2.022, p = 0.043). The C-reactive protein level at 72nd postoperative hour was also significantly lower in Group S (Z = -2.134, p = 0.003).<h4>Conclusions</h4>Esketamine can decrease the incidence of POD, reduce postoperative inflammatory levels, and alleviate short-term inflammatory responses in OPCAB patients.

Topics & conditions

Detected automatically by Psychedelic Commons from the title and abstract, not labels from the source. They may be incomplete.

Keywords