Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis

Viderman D. Aubakirova M. Nabidollayeva F. Yegembayeva N. Bilotta F. Badenes R. Abdildin Y.
July 2023 Multidisciplinary Digital Publishing Institute (MDPI)

Journal of Clinical Medicine
2023 #12 Issue 13

Background: Neurocognitive alterations in the perioperative period might be caused by a wide variety of factors including pain, blood loss, hypotension, hypoxia, micro- and macroemboli, cardiopulmonary bypass (CPB), reperfusion damage, and surgery itself, and all are risk factors for developing postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The objective of this study was to evaluate the effect of ketamine on neurocognitive dysfunction after anesthesia. Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) comparing ketamine use (experimental group) with placebo (controls). Results: The model favors the control group over the experimental group in terms of frequency of hallucinations (the risk ratio with 95% CI is 1.54 [1.09, 2.19], p-value = 0.02), the number of patients readmitted within 30 days (RR with 95% CI is 0.25 [0.09, 0.70]), and the number of adverse events (overall RR with 95% CI is 1.31 [1.06, 1.62]). In terms of morphine consumption, the model favors the experimental group. Conclusion: There was no statistically significant difference in incidences of postoperative delirium, vasopressor requirement, and fentanyl consumption between the ketamine and control groups. However, hallucinations were more frequently reported in the ketamine group.

anesthesia , delirium , ketamine , neurocognitive dysfunction , postoperative cognitive dysfunction

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Department of Biomedical Sciences, Nazarbayev University School of Medicine (NUSOM), Kerei and Zhanibek Khandar Str. 5/1, Astana, 010000, Kazakhstan
Department of Anesthesiology and Intensive Care, National Research Oncology Center, Astana, 010000, Kazakhstan
School of Engineering and Digital Sciences, Nazarbayev University, Astana, 010000, Kazakhstan
Department of Anesthesia and Intensive Care, University La Sapienza, Rome, 00185, Italy
Department of Anaesthesiology and Intensive Care, Hospital Clìnico Universitario de Valencia, University of Valencia, Valencia, 46003, Spain

Department of Biomedical Sciences
Department of Anesthesiology and Intensive Care
School of Engineering and Digital Sciences
Department of Anesthesia and Intensive Care
Department of Anaesthesiology and Intensive Care

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