{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:18:37Z","timestamp":1792631917369,"version":"4.5.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delirium is a common and serious complication in critically ill and surgical patients, associated with increased morbidity, prolonged hospitalization, and long-term cognitive impairment. Ketamine and esketamine have been proposed as potential protective agents due to their anti-inflammatory, analgesic, and NMDA receptor-blocking properties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the use of ketamine or esketamine for the prevention of delirium in adult surgical patients, some of whom required postoperative Intensive Care Unit (ICU) level care. The primary outcome was the incidence of delirium. Secondary outcomes included pain assessment, opioid consumption, ICU and hospital length of stay, mortality, and neuropsychiatric adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool. This review was registered in PROSPERO (CRD420251061137) and conducted according to PRISMA 2020 guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight RCTs involving a total of 1645 patients were included. Ketamine or esketamine significantly reduced the incidence of delirium compared to placebo (odds ratio [OR]\u2009=\u2009\n                      <jats:underline>0.<\/jats:underline>\n                      50; 95% CI: 0.28-0.91; p\u2009=\u2009.02). Subgroup analysis revealed a significant benefit in older adults (mean age &gt; 60 years), but not in younger populations. Neuropsychiatric adverse events\u2014such as hallucinations and nightmares\u2014were more frequent in the ketamine group (OR\u2009=\u20091.60; 95% CI: 1.15-2.21; p\u2009=\u2009.005). No consistent effects were observed on pain scores, opioid consumption, or length of stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ketamine and esketamine may reduce the incidence of delirium in surgical patients, particularly in older adults, although this benefit must be weighed against a higher incidence of neuropsychiatric symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666251410471","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T18:01:41Z","timestamp":1767808901000},"page":"765-775","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Ketamine and Esketamine for the Prevention of Delirium in Surgical Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9099-9224","authenticated-orcid":false,"given":"Nestor Cordeiro dos","family":"Santos Neto","sequence":"first","affiliation":[{"name":"Hospital do Cora\u00e7\u00e3o de Messejana"},{"name":"Postoperative Intensive Care Unit, Hospital Otocl\u00ednica, Fortaleza, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimundo Pires","family":"Montenegro Neto","sequence":"additional","affiliation":[{"name":"Universidade de Fortaleza (UNIFOR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther Frota","family":"Gomes","sequence":"additional","affiliation":[{"name":"Universidade de Fortaleza (UNIFOR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Carvalho Lima","family":"Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"Universidade de Fortaleza (UNIFOR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Bastos","family":"Porto","sequence":"additional","affiliation":[{"name":"Postoperative Intensive Care Unit, Hospital Otocl\u00ednica, Fortaleza, CE, Brazil"},{"name":"Universidade Federal do Cear\u00e1 (UFC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoel Amora Albano","family":"Amora Neto","sequence":"additional","affiliation":[{"name":"Postoperative Intensive Care Unit, Hospital Otocl\u00ednica, Fortaleza, CE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucilaide Oliveira","family":"Santos","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o de Medicina Tropical do Amazonas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildegard Loren Rebou\u00e7as","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo (UNIFESP)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_180_16"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0695-x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.2273"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.14.1753"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.5811\/WESTJEM.59383"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2018.07.011"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2538"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301372"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2017.07.002"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182783b72"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.7200"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1904710"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.304"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.22.2644"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.56"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005651"},{"issue":"1","key":"e_1_3_2_20_2","first-page":"47","article-title":"The anti-inflammatory effects of ketamine: State of the art","volume":"62","author":"Loix S","year":"2011","unstructured":"Loix S, De Kock M, Henin P. 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