Journal of International Psychiatry

[Abstract] Objective To investigate the effect of low-dose esketamine on early cognitive function after hip surgery in elderly patients. Methods A total of 120 patients with hip disorders from January 2021 to December 2022 were selected and all were treated surgically in this study. By the numerical table method, they were randomized into three groups, namely, low-dose group (esketamine 0.25 mg/kg), high-dose group (esketamine 0.5 mg/kg), and control group (conventional anesthesia). The Montreal Cognitive Assessment Scale (MoCA) as well as serum interleukin 6 (IL-6) and central nervous specific protein (S100-β protein) levels were compared between the three groups before, 1d, 3d and 5d after surgery. Results The 1d, 3d, and 5d postoperative MoCA scores were lower than those before surgery in all three groups, and the 1d and 3d postoperative MoCA scores were significantly higher in the low-dose and high-dose groups than in the control group (P<0.05). There was no statistically significant difference between the low-dose group and the high-dose group at each time point and the 5d postoperative MoCA scores of the three groups (P>0.05). Serum IL-6 and S100-β protein levels were significantly higher in the three groups at 1d, 3d and 5d postoperatively than preoperatively, and significantly lower in the low-dose and high-dose groups than in the control group at all time points (P<0.05). The 1d postoperative level in the low-dose group was significantly higher than that in the high-dose group, and the differences between the two groups at the remaining time points were not statistically significant (P>0.05). Conclusion Esketamine improves early cognitive function after hip surgery in elderly patients, reduces inflammatory factors and S100β protein levels, and small doses of esketamine achieve consistent cognitive function protection at high doses.

Key words Low Dose; Esketamine; Elderly; Hip Surgery; Postoperative Cognitive Function