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Perioperative ketamine for acute postoperative pain
R F Bell1, J B Dahl, R A Moore
1Haukeland University Hospital/ University of Bergen, Pain Clinic/Dept. of Surgical Sciences, Bergen, Norway, N-5021. rbel@haukeland.no
The Cochrane Database of Systematic Reviews
|January 27, 2006
Summary
Perioperative ketamine effectively reduces postoperative pain and nausea, lowering the need for rescue analgesics. This opioid-sparing approach offers significant benefits with minimal side effects.
Area of Science:
- Anesthesiology and Pain Management
- Pharmacology
- Evidence-Based Medicine
Background:
- Postoperative pain management is challenged by adverse effects of traditional analgesics.
- Ketamine, an inexpensive opioid-sparing drug, shows potential for improved analgesia with fewer side effects.
Purpose of the Study:
- To evaluate the efficacy and tolerability of perioperative ketamine for acute postoperative pain in adults.
- To assess ketamine's impact on analgesic requirements and adverse events.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searches included MEDLINE, EMBASE, Cochrane Library, and manufacturer databases (1966-2004).
- Included RCTs compared perioperative ketamine with placebo in adult surgical patients.
Main Results:
- Thirty-seven RCTs involving 2240 participants were included.
- Subanesthetic doses of ketamine reduced pain intensity and rescue analgesic needs in 27 trials.
- Ketamine significantly decreased 24-hour morphine consumption and postoperative nausea or vomiting (PONV).
Conclusions:
- Subanesthetic ketamine is effective in reducing postoperative morphine requirements within 24 hours.
- Ketamine also effectively reduces the incidence of postoperative nausea and vomiting.
- Reported adverse effects associated with ketamine were mild or absent.