Effect of Low-dose EsketaMine on dElirium in High-risk Elderly Patients uNdergoing elecTive Surgery (ELEMENT)

This double-blind, placebo-controlled trial (n=1670) will assess the effect of low-dose esketamine on postoperative delirium in elderly high-risk patients undergoing major non-cardiac surgery. Participants will receive either esketamine (14mg/70kg loading dose, followed by 7mg/70kg/h infusion) or a placebo during surgery, with esketamine included in postoperative patient-controlled analgesia.

Delirium, a temporary state of confusion that can occur after surgery, is particularly common in older adults and is linked to worse long-term health outcomes. While esketamine, a variant of ketamine, has anti-inflammatory and neuroprotective effects, previous studies on its ability to prevent postoperative delirium have been inconclusive. This large-scale, multicentre trial, conducted by Nanfang Hospital, Southern Medical University, aims to clarify whether esketamine can reduce delirium incidence and improve recovery. The study will measure delirium occurrence, pain levels, opioid use, cognitive function, and overall recovery within 30 days after surgery.

Topic Neurocognitive Disorders
Compound Ketamine Placebo
Country China
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