Preoperative ketamine administration for prevention of postoperative neurocognitive disorders after major orthopedic surgery in elderly patients: A multicenter randomized blinded placebo-controlled trial
Primary result · Objective dNRResult — go to the resultOdds ratio 0.92 95% CI 0.56–1.51Authors' conclusion
A single preoperative bolus of intravenous ketamine does not prevent the occurrence of dNR or POND in elderly patients scheduled for major orthopedic surgery.
Study context
- Population
- Patients ≥60 years undergoing major orthopedic surgery292 (97%) completed
- Participants
- 301 patients
- Comparison
- Preoperative IV ketamine 0.5 mg/kg bolus vs placebo
- Ketaminen = 152
- Placebon = 149reference
- Primary endpoint
- Objective delayed neurocognitive recovery (dNR): decline of ≥1 neuropsychological assessment SD
- Follow-up
- POD 7
Methodological detailsmulticentre, double-blind, placebo-controlled, stratified block randomisation
- Multicentre
- Double-blind
- Placebo-controlled
- Stratified block randomisation
Primary result
Objective dNR
Odds ratio
0.92
95% CI 0.56–1.51
P = 0.73
Events by treatment group
Ketamine vs Placebo
OR 0.92 (95% CI 0.56–1.51); P = 0.73
As reported in the abstract
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Symptoms of depression · 3 monthsLess frequent in the ketamine group | 0.34 (0.13–0.86) | |
| 0.10.31310Odds ratio (log scale) |
Objective postoperative neurocognitive disorder (POND), delirium, anxiety, apathy, fatigue · 3 months
- No significant difference between the two groups
Original publication
Preoperative ketamine administration for prevention of postoperative neurocognitive disorders after major orthopedic surgery in elderly patients: A multicenter randomized blinded placebo-controlled trial. Anaesth Crit Care Pain Med. Published 6 May 2024. doi:10.
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