Key result
Perioperative ketamine slightly reduced pain scores (1-7 mm on a 100 mm scale) and opioid consumption (0.5-1 mg/hr) in the first 48 hours, but these reductions did not reach clinical importance.
Why the study?
Ketamine was investigated as an opioid alternative for postoperative pain, but its efficacy and safety profile warranted evaluation.
Does perioperative intravenous ketamine reduce post-operative pain and opioid consumption in adults undergoing surgery?
Meta-Analysis (n=8,341)
Does perioperative intravenous ketamine reduce post-operative pain and opioid consumption in adults undergoing surgery?
Effect estimate: 1 to 7 mm reduction on 100 mm VAS; 0.5-1 mg/hr reduction in opioid consumption
Perioperative ketamine provides statistically significant but clinically unimportant reductions in acute postoperative pain and opioid consumption, with an unclear safety profile for widespread use.
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Opioid-free protocols provide noninferior pain control after common orthopaedic procedures; supports shifting perioperative management away from routine opioid use.
Ekhtiari et al. (2019) conducted a meta-analysis in Acute postoperative pain (n=8,341). Perioperative intravenous ketamine vs. Placebo, opioid medication, or non-steroidal anti-inflammatory was evaluated on Pain scores (VAS) and opioid consumption in the first 48 hours (1 to 7 mm reduction on 100 mm VAS; 0.5-1 mg/hr reduction in opioid consumption). Perioperative ketamine slightly reduced pain scores (1-7 mm on a 100 mm scale) and opioid consumption (0.5-1 mg/hr) in the first 48 hours, but these reductions did not reach clinical importance.
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