# Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients

## TL;DR

This study shows that low doses of esketamine may help protect cognitive function in elderly stroke patients after surgery.

## Contribution

The novel finding is that subclinical esketamine reduces cognitive dysfunction and NLRP3 inflammation in elderly stroke patients.

## Key findings

- Elderly stroke patients given esketamine had better cognitive scores after surgery.
- Esketamine reduced levels of NLRP3 and other inflammatory markers.
- NLRP3 levels were linked to cognitive outcomes in stroke patients.

## Abstract

This study investigates the effects of subclinical doses of esketamine on serum NLRP3 levels and early cognitive dysfunction in elderly ischemic stroke patients after neurointerventional procedures under general anesthesia.

A prospective cohort study included 120 elderly ischemic stroke patients undergoing general anesthesia from January 2022 to September 2023. The esketamine group received 0.25 mg/kg of esketamine. Serum levels of NLRP3, C-reactive protein, interleukin-6 (IL-6), IL-1β, and IL-17 were measured before surgery and 24 h postoperatively. Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE).

At 24 h postoperatively, the esketamine group had significantly higher MMSE scores (p < 0.05) and lower serum levels of NLRP3, IL-17, and IL-6. Pearson’s correlation showed a link between NLRP3 levels and cognitive outcomes. Logistic regression identified heart rate, mean arterial pressure, preoperative NLRP3, IL-6, IL-17, and esketamine treatment as risk factors for cognitive dysfunction.

Subclinical doses of esketamine might reduce postoperative cognitive dysfunction risk and offer neuroprotection, presenting potential therapeutic options for elderly ischemic stroke patients.