Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial

Hollinger, Alexa; Rüst, Christoph Alexander; Riegger, Harriet; Gysi, Bianca; Tran, Fabian; Brügger, Jonas; Huber, Jan Patrick; Toft, Katharina; Surbeck, Madlen; Schmid, Hans-Ruedi; Rentsch, Katharina; Steiner, Luzius A.; Siegemund, Martin

doi:10.1016/j.jclinane.2020.110099

Cited by 41 publications

(42 citation statements)

References 33 publications

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“…Ketamine, a sedative with an analgesic effect, is widely used in orthopedic surgery in patients who concurrently sustained burn injuries. The brain-derived biomarkers, S100β and NSE, decrease after ketamine administration ( Hollinger et al, 2021 ). The neuroprotective effect of ketamine may also be related to a reduction in postoperative systemic inflammation.…”

Section: Advances In Treatmentmentioning

confidence: 99%

Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction

Wang

Chen

Zhang

et al. 2021

Front. Aging Neurosci.

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Sevoflurane is one of the most widely used anesthetics for the induction and maintenance of general anesthesia in surgical patients. Sevoflurane treatment may increase the incidence of postoperative cognitive dysfunction (POCD), and patients with POCD exhibit lower cognitive abilities than before the operation. POCD affects the lives of patients and places an additional burden on patients and their families. Understanding the mechanism of sevoflurane-induced POCD may improve prevention and treatment of POCD. In this paper, we review the diagnosis of POCD, introduce animal models of POCD in clinical research, analyze the possible mechanisms of sevoflurane-induced POCD, and summarize advances in treatment for this condition.

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Section: Advances In Treatmentmentioning

confidence: 99%

Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction

Wang

Chen

Zhang

et al. 2021

Front. Aging Neurosci.

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“…The study investigated the drugs separately and in combined form in comparison with the controlled group amongst 182 patients. The study found no prevention of cognitive decline postoperatively [ 53 ]. However, the study also found a significant decline of inflammatory markers with the use of ketamine postoperatively compared with the placebo group, suggesting ketamine’s neuroprotective action on neurons, glial cells, and astrocytes [ 53 ].…”

Section: Recent Clinical Findingsmentioning

confidence: 99%

“…The study found no prevention of cognitive decline postoperatively [ 53 ]. However, the study also found a significant decline of inflammatory markers with the use of ketamine postoperatively compared with the placebo group, suggesting ketamine’s neuroprotective action on neurons, glial cells, and astrocytes [ 53 ]. With studies showing increased levels of the neurotoxin quinolinic acid (QUIN), increased extracellular NMDA receptor agonists, and increased neuronal and glial cell death associated with AD, ketamine with opposing actions could be a practical approach for AD treatment [ 54 ].…”

Section: Recent Clinical Findingsmentioning

confidence: 99%

The Possible Application of Ketamine in the Treatment of Depression in Alzheimer’s Disease

Shehata

Masood

Nemr

et al. 2022

Neurology International

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Depression is a leading cause of disability globally, with a prevalence of 3.8% among the whole population, 5% of the adult population, and 5.7% of the elderly population over 60 years of age. There is evidence that depression is linked to certain neurodegenerative diseases, one being Alzheimer’s disease (AD). The efficacy of conventional antidepressants to treat depression in AD is conflicting, especially regarding selective serotonin reuptake inhibitors (SSRIs). A recent systemic review and meta-analysis of 25 randomized controlled trials including fourteen antidepressant medications showed no high efficacy in treating AD patients’ symptoms. However, ketamine, a nonselective N-methyl-D-aspartate (NMDA) receptor antagonist, can mediate a wide range of pharmacological effects, including neuroprotection, anti-inflammatory and anticancer properties, multimodal analgesia, and treatment of depression, suicidal attempts, and status epilepticus. Esketamine, which is ketamine formulated as a nasal spray, was approved by the Federal Drug Administration (FDA) in March 2019 as an adjuvant drug to treat treatment-resistant depression. NMDA receptor antagonists treat AD through offsetting AD-related pathological stimulation of subtypes of glutamate receptors in the central nervous system. Recent clinical findings suggest that ketamine may provide neuroprotection and reduce neuropsychiatric symptoms associated with AD. In the present investigation, we evaluate the potential role of ketamine and its postulated mechanism in AD management.

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“…79 A comparative study of ketamine and haloperidol failed to show a difference in prevention of cognitive dysfunction or prevention of postoperative delirium. 80…”

Section: Ventilationmentioning

confidence: 99%

Updated Perspectives on the Management of Sleep Disorders in the Intensive Care Unit

Nilius¹,

Richter²,

Schroeder³

2021

NSS

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Sleep disorders and circadian dysrhythmias are extremely prevalent in critically ill patients. Impaired sleep has a variety of etiologies, exhibits a wide range of negative effects and, moreover, might deteriorate the patient's prognosis. Despite a number of scientific findings and increased awareness, the importance of sleep optimization is still lower on the list of priories in the intensive care unit (ICU). The techniques of measuring and the evaluation of sleep quantity and quality are a great challenge in the ICU setting. The subjective and objective tools of sleep validation continue to suffer from deficiencies. Treatment approaches to improve the critically ill patient's sleep have focused on nonpharmacologic and pharmacologic strategies with some promising results. But pharmacological interventions alone could not provide sufficient patient benefit. Being aware and knowing of sleep problems and the beneficial effect of the necessary therapies in ICU patients requires greater acceptance. The application of available methods and the development of new methods to prevent sleep disorders in the ICU offer the potential to improve the critically ill patient's outcome.

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Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial

Cited by 41 publications

References 33 publications

Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction

Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction

The Possible Application of Ketamine in the Treatment of Depression in Alzheimer’s Disease

Updated Perspectives on the Management of Sleep Disorders in the Intensive Care Unit

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