Impact of Esketamine on Delayed Neurocognitive Recovery in Older Patients

Esketamine is frequently used during the perioperative period for supplemental analgesia. Small sample size trials showed that subanesthetic dose esketamine may decrease postoperative neurocognitive complications. However, conflicting results exist and optimal dose of esketamine remains to be determined. This dose-exploring pilot trial is designed to evaluate the safety and efficacy of three different perioperative esketamine dosing regimens in older patients undergoing major non-cardiac surgery. The primary purpose is to explore the optimal dosing strategy that produce maximal neurocognitive benefits with minimal adverse neuropsychiatric symptoms.

NCT Number	NCT07523334
Lead Sponsor	Peking University First Hospital Collaborators: Tianjin Medical University General Hospital
Conditions	Elderly, Noncardiac Surgery, Delayed Neurocognitive Recovery, Postoperative Delirium, Esketamine
Enrollment	120 participants
Start Date	2026-04
Primary Completion	2026-12 (estimated)
Study Completion	2026-12 (estimated)
Updated on ClinicalTrials.gov	2026-04-14