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

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 post...

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Autores principales: Viderman, Dmitriy, Aubakirova, Mina, Nabidollayeva, Fatima, Yegembayeva, Nurgul, Bilotta, Federico, Badenes, Rafael, Abdildin, Yerkin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342373/
https://www.ncbi.nlm.nih.gov/pubmed/37445346
http://dx.doi.org/10.3390/jcm12134314
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author Viderman, Dmitriy
Aubakirova, Mina
Nabidollayeva, Fatima
Yegembayeva, Nurgul
Bilotta, Federico
Badenes, Rafael
Abdildin, Yerkin
author_facet Viderman, Dmitriy
Aubakirova, Mina
Nabidollayeva, Fatima
Yegembayeva, Nurgul
Bilotta, Federico
Badenes, Rafael
Abdildin, Yerkin
author_sort Viderman, Dmitriy
collection PubMed
description 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.
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spelling pubmed-103423732023-07-14 Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis Viderman, Dmitriy Aubakirova, Mina Nabidollayeva, Fatima Yegembayeva, Nurgul Bilotta, Federico Badenes, Rafael Abdildin, Yerkin J Clin Med Review 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. MDPI 2023-06-27 /pmc/articles/PMC10342373/ /pubmed/37445346 http://dx.doi.org/10.3390/jcm12134314 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Viderman, Dmitriy
Aubakirova, Mina
Nabidollayeva, Fatima
Yegembayeva, Nurgul
Bilotta, Federico
Badenes, Rafael
Abdildin, Yerkin
Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis
title Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis
title_full Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis
title_fullStr Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis
title_full_unstemmed Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis
title_short Effect of Ketamine on Postoperative Neurocognitive Disorders: A Systematic Review and Meta-Analysis
title_sort effect of ketamine on postoperative neurocognitive disorders: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342373/
https://www.ncbi.nlm.nih.gov/pubmed/37445346
http://dx.doi.org/10.3390/jcm12134314
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