Effects of esketamine combined with dexmedetomidine on postoperative delirium and quality of recovery in elderly patients undergoing thoracoscopic radical lung cancer surgery: a randomized controlled trial

作者：Cong-Li Zhang, Yan Yan, Yang Zhang, Han-Lin Bai, Zhuang Qin, Nan-Nan Song, Chuan-Jiang Feng, Lijuan Xie, Si-Yi Wang, Xiaohong Li, Liu D, Li Ren · 发表于：CNS Spectrums · 年份：2024 · DOI：10.1017/s1092852924002177 · 被引用次数：9 · 研究领域：Intensive Care Unit Cognitive Disorders、Cancer, Stress, Anesthesia, and Immune Response、Nausea and vomiting management

Abstract Objective This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery. Methods In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3 + , CD4 + , and CD8 + were detected from T0 to T5. Results Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8 + were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3 + and CD4 + /CD8 + values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4 + value increased significantly (P < 0.01). The incidence of n...