Related Experiment Video
Updated: Aug 5, 2026

The Adjuvant Efficacy of Angong Niuhuang Pill in the Treatment of Viral Encephalitis: A Meta-Analysis of Randomized Controlled Trials
Published on: April 19, 2024
Efficacy of Perineural Ketamine as an Adjuvant in Regional Anesthesia: A Systematic Review and Meta-Analysis
Dhruv Jain1, Sana Yasmin Hussain1, Shailendra Kumar1
1Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Ketamine is an N-methyl-D-aspartate antagonist which possesses anti-nociceptive and local anesthetic properties. The aim of the meta-analysis is to assess the analgesic efficacy of perineural ketamine as an adjuvant to local anesthetics for regional nerve blocks. Randomized controlled trials (RCTs) comparing ketamine as an adjuvant to local anesthetic solution in regional nerve blocks in adult patients undergoing elective surgeries were systematically searched from databases-PubMed, Embase, CENTRAL from inception till June 2024. The primary objective was the duration of analgesia. Secondary objectives included postoperative opioid requirement, onset and duration of nerve block, and complications. A total of 25 RCTs (1,178 patients) were included. Duration of analgesia was significantly longer (mean difference [MD], 142.86 minutes; 95% confidence interval [CI], [107.75, 177.97]; P < 0.001) and opioid requirement was lower (standardized mean difference [SMD], -1.42; 95% CI, [-1.95, -0.89; P < 0.0001) when ketamine was used as an adjuvant for regional nerve blocks. Duration of sensory block was prolonged significantly in the ketamine group (MD, -15.07 minutes; 95% CI, [4.34, 25.80]; P = 0.006), and duration of motor block was similar. The complication rates were similar, but it was higher in the peripheral nerve block on subgroup analysis. The use of ketamine as an adjuvant to local anesthetics in regional nerve blocks for surgeries leads to longer duration of analgesia, sensory block, and lower opioid requirement with similar complication rates.
Related Concept Videos
Parenteral Anesthetics: Overview
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Pharmacokinetics
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia