Single Dose of Ketamine During Kyphoplasty Procedures Does Not Reduce Postoperative Narcotic Consumption

This retrospective cohort study aimed to explore the study institution’s intraoperative ketamine use during kyphoplasty and compare narcotic requirements in patients who received intraoperative ketamine with those who did not. The authors hypothesized that a single dose of ketamine during kyphoplasty would reduce postoperative narcotic consumption. Included patients underwent kyphoplasty under monitored anesthesia care between 2012 and 2013. Excluded patients were younger than 18 years or had general anesthesia, endotracheal intubation, or major intraoperative complications. Narcotics were converted into morphine equivalents for comparison. Analysis included c², correlation analyses, multivariate regression analysis, and analysis of variance. Overall, 279 patients were included. Men were a minority of the sample, 26.2% (73/279). More than 83% of patients were ASA class 3 (232/279), and more than 50% repaired a single vertebra (154/279). A single dose of ketamine was administered in 15.8% of kyphoplasties, with an average dose of 38.7 mg (range = 2-150 mg). Intraoperative ketamine administration was predictive of decreased intraoperative narcotic requirements (P < .001) but was not associated with decreased postoperative narcotic requirements (P = .442). Patients remained hemodynamically stable in the preoperative and postoperative period. Ketamine did not reduce postoperative narcotic consumption but reduced intraoperative narcotic consumption in this sample.