Table 1 Characteristics of the included trials
From: Esketamine and neurocognitive disorders in adult surgical patients: a meta-analysis
No | First author | Year | Number (S/C) | Age,y (S/C) | Sex, male/ female (S/C) | BMI, kg/m2 (S/C) | ASA I/II/III (S/C) | Surgical procedure | Primary anesthetic | Esketamine group | Control group |
1 | Bornemann Cimenti | 2016 | 18/19/ 19 | 62.2 ± 9.8/ 58.4 ± 8.1/ 61.0 ± 12.4 | 9/9, 8/11, 8/11 | / | 1/5/12, 0/11/8, 3/8/8 | Open abdominal surgery | GA + PCIA (BA) | Low-dose group: 0.25 mg/kg IV bolus after induction of anesthesia + 0.125 mg/kg/h continuous IV infusion for 48 h Minimal-dose group:0.9% saline bolus after induction of anesthesia + 0.015 mg/kg/h continuous IV infusion for 48 h | Normal saline |
2 | Xiaodan Chen | 2022 | 37/37 | 57.14 ± 5.94/56.46 ± 6.07 | 19/17,17/20 | 22.81 ± 1.65/ 22.56 ± 1.46 | 13/21/3,15/18/4 | thoracoscopic radical lung cancer surgery | GA + TPVB + PCIA (BA) | 0.3 mg/kg IV during induction of anaesthesia + 0.2 mg/kg/h continuous IV infusion stopped 30 min before the end of surgery | / |
3 | Chao Han | 2023 | 33/34 | 70.60 ± 7.63/70.00 ± 6.25 | 18/15, 19/15 | 23.13 ± 3.42/ 23.21 ± 2.40 | / | gastrointestinal surgery | GA(TIVA) | 0.15 mg/kg IV before the initiation of surgery | normal saline |
4 | Tiantian Liu | 2023 | 20/19 | 46.25 ± 6.77/44.37 ± 9.74 | / | 22.68 ± 2.81/ 22.92 ± 2.60 | 3/17/0, 1/18/0 | laparoscopic gynecological surgery | GA | 0.125 mg/kg IV 30 min after the start of surgery | normal saline |
No | First author | Year | Number (S/C) | Age,y (S/C) | Sex, m/f (S/C) | BMI,kg/m2(S/C) | ASA I/II/III (S/C) | Surgical procedure | Primary anesthetic | Esketamine group | Control group |
5 | Jiamin Ma | 2023 | 31/31 | 69.45 ± 4.4/70.55 ± 4.2 | 24/7, 24/7 | 22.75 ± 2.76/ 23.64 ± 3.36 | 0/25/6, 0/24/7 | major abdominal surgery | GA | 0.25 mg/kg IV for induction + 0.125 mg/kg/h continuous IV infusion stopped 20 min before the end of surgery | normal saline |
6 | Junxia Zhang | 2023 | 40/40 | 52.6 ± 10.9/ 54.9 ± 9.9 | 0/40,0/40 | 23.3 (22.2–24.2), 23.7 (22.5–25.9) | 10/30/0, 8/32/0 | modified radical mastectomy | GA + PCIA (TIVA) | 0.5 mg/kg for induction + 0.5 mg/kg/h continuous IV infusion stopped 30 min before the end of surgery | sufentanil |
7 | Jingjing Yuan | 2022 | 30/29/ 23 | 55 ± 11/ 56 ± 12/ 53 ± 12 | 9/21, 6/23, 7/16 | 23(22–25), 24(22–26), 24(21–25) | 20/10/0,19/10/0,13/10/0 | thoracoscopic lung surgery | GA + PCIA (TIVA) | Low-dose group: 0.15 mg/kg/h continuous IV infusion during surgery sub anesthesia-dose group: 0.25 mg/kg/h continuous IV infusion during surgery | normal saline |
8 | Wencai Tu | 2021 | 40/40 | 66.01 ± 5.4/65.27 ± 5.2 | 20/20, 22/18 | 22.39 ± 1.75, 22.16 ± 1.71 | / | Spinal Surgery | GA (TIVA) | 0.5 mg/kg for induction | sufentanil |
9 | Zhaojun Jing | 2024 | 44/43 | 69.2 ± 6.22/71.47 ± 6.2 | 30/14, 26/17 | 23.02 ± 2.19/23.54 ± 2.58 | 0/35/9, 0/34/9 | laparoscopic gastrointestinal tumor surgery | TAPB + GA + PCIA (TIVA) | 0.25 mg/kg IV after induction + 0.1 mg/kg/h continuous IV infusion stopped before the end of surgery | normal saline |
No | First author | Year | Number (S/C) | Age,y (S/C) | Sex,m/f (S/C) | BMI,kg/m2(S/C) | ASA I/II/III (S/C) | Surgical procedure | Primary anesthetic | Esketamine group | Control group |
10 | Tianyuan Luo | 2024 | 42/45/42 | 55.95 ± 9.1/55.2 ± 9.23/55.9 ± 10.6 | 19/23, 23/22, 22/20 | 23.48 ± 3.73/23.02 ± 3.31/23.59 ± 3 | 1/39/2,0/39/6,0/38/4 | non-cardiac thoracic surgery | GA + PCIA (TIVA) | Low-dose group: 0.2 mg/kg IV for induction High-dose group: 0.5 mg/kg IV for induction | normal saline |
11 | Yujia Wang | 2024 | 70/70 | 77.71 ± 7.57/76.9 ± 7.99 | 33/37, 38/32 | 26.01 ± 5.26/25.94 ± 4.18 | 10/35/25,12/32/26 | Thoracic surgery | GA | 0.5 mg/kg IV for induction | normal saline |
12 | Xinglong Xia | 2024 | 56/56 | 51.1 ± 9.9/ 51.6 ± 6.7 | 26/30, 26/30 | 22.9 ± 3.3/ 22.7 ± 4 | 0/14/42,0/13/43 | on-pump cardiac valve surgery | GA + PCIA (BA) | 0.5 mg/kg IV before anesthesia induction | normal saline |
13 | Jing Liu | 2024 | 30/30 | / | 21/9, 18/12 | / | / | / | GA + PCIA (TIVA) | 1 mg/kg for PCIA | normal saline |