Ketamine and postoperative pain – a quantitative systematic review of randomised trials

@article{Elia2005KetamineAP,
  title={Ketamine and postoperative pain – a quantitative systematic review of randomised trials},
  author={Nadia Elia and Martin R. Tram{\`e}r},
  journal={Pain},
  year={2005},
  volume={113},
  pages={61-70}
}
Ketamine, an N-methyl-D-aspartate receptor antagonist, is known to be analgesic and to induce psychomimetic effects. [...] Key Method We systematically searched for randomised comparisons of ketamine with inactive controls in surgical patients, reporting on pain outcomes, opioid sparing, and adverse effects. Data were combined using a fixed effect model. Fifty-three trials (2839 patients) from 25 countries reported on a large variety of different ketamine regimens and surgical settings. Sixteen studies tested…Expand
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References

SHOWING 1-10 OF 87 REFERENCES
Ketamine in Chronic Pain Management: An Evidence-Based Review
TLDR
The evidence for efficacy of ketamine for treatment of chronic pain is moderate to weak, however, in situations where standard analgesic options have failed ketamine is a reasonable “third line” option. Expand
Adding Ketamine to Morphine for Patient-Controlled Analgesia After Major Abdominal Surgery: A Double-Blinded, Randomized Controlled Trial
TLDR
It is concluded that small-dose ketamine combined with PCA morphine provides no benefit to patients undergoing major abdominal surgery. Expand
A Single Small Dose of Postoperative Ketamine Provides Rapid and Sustained Improvement in Morphine Analgesia in the Presence of Morphine-Resistant Pain
TLDR
The effects of postoperative coadministration of small doses of ketamine and morphine on pain intensity, Spo2, and subjectively rated variables in surgical patients who underwent standardized general anesthesia and complained of pain despite >0.1 mg/kg of IV morphine administration within 30 min are evaluated. Expand
[Lack of pre-emptive analgesic effect of low-dose ketamine in postoperative patients. A prospective, randomised double-blind study].
TLDR
It is concluded that under the study conditions used, low dose ketamine, contrary to previously reported results, does not provide a clinically relevant pre-emptive analgesic effect in postoperative patients. Expand
Use and efficacy of low-dose ketamine in the management of acute postoperative pain: a review of current techniques and outcomes
TLDR
It is concluded that ketamine may provide clinicians with a tool to improve postoperative pain management and to reduce opioid related adverse effects and dose-finding studies for ketamine as an adjunct to opioids and local anesthetics are required. Expand
Perioperative Small-Dose S(+)-Ketamine Has No Incremental Beneficial Effects on Postoperative Pain When Standard-Practice Opioid Infusions Are Used
TLDR
In this study, S(+)-ketamine did not contribute to postoperative pain reduction, possibly because of the clinically routine perioperative opioid analgesia. Expand
Adding Ketamine in a Multimodal Patient-Controlled Epidural Regimen Reduces Postoperative Pain and Analgesic Consumption
TLDR
It is concluded that adding ketamine 0.4 mg/mL in a multimodal PCEA regimen provides better postoperative pain relief and decreases consumption of analgesics. Expand
The addition of ketamine to patient controlled morphine analgesia does not improve quality of analgesia after total abdominal hysterectomy
TLDR
The results have not confirmed that the addition of low-dose ketamine to a standard anaesthetic/postoperative regimen in total abdominal hysterectomy patients provides any improvement in analgesia, morphine sparing effect or a reduction in adverse effects (except sedation). Expand
Sensory Changes and Pain After Abdominal Hysterectomy: A Comparison of Anesthetic Supplementation with Fentanyl Versus Magnesium or Ketamine
TLDR
Generalized central sensory inhibition, differently affected by the drugs, predominated after surgery, and all adjuvants suppressed spinal sensitization after surgery. Expand
Postoperative pain management with intravenous patient‐controlled morphine: comparison of the effect of adding magnesium or ketamine
TLDR
In the immediate postoperative period, the addition of magnesium or ketamine to morphine for intravenous patient‐controlled analgesia led to a significantly lower consumption of morphine. Expand
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