Document Detail

Peri-operative ketamine for acute post-operative pain: a quantitative and qualitative systematic review (Cochrane review).
MedLine Citation:
PMID:  16223384     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Post-operative pain management is usually limited by adverse effects such as nausea and vomiting. Adjuvant treatment with an inexpensive opioid-sparing drug such as ketamine may be of value in giving better analgesia with fewer adverse effects. The objective of this systematic review was to evaluate the effectiveness and tolerability of ketamine administered peri-operatively in the treatment of acute post-operative pain in adults. METHODS: Studies were identified from MEDLINE (1966-2004), EMBASE (1980-2004), the Cochrane Library (2004) and by hand searching reference lists from review articles and trials. The manufacturer of ketamine (Pfizer AS, Lysaker, Norway) provided search results from their in-house database, PARDLARS. Randomized and controlled trials (RCTs) of adult patients undergoing surgery, being treated with peri-operative ketamine, placebo or an active control were considered for inclusion. RESULTS: Eighteen trials were excluded. Thirty-seven trials were included. Twenty-seven out of 37 trials found that peri-operative ketamine reduced rescue analgesic requirements or pain intensity, or both. Quantitative analysis showed that treatment with ketamine reduced 24-h patient-controlled analgesia (PCA) morphine consumption and post-operative nausea and vomiting (PONV). Adverse effects were mild or absent. CONCLUSION: In the first 24 h after surgery, ketamine reduces morphine requirements. Ketamine also reduces PONV. Adverse effects are mild or absent. These data should be interpreted with caution as the retrieved studies were heterogenous and the result of the meta-analysis can not be translated into any specific administration regimen with ketamine.
R F Bell; J B Dahl; R A Moore; E Kalso
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  49     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-14     Completed Date:  2006-01-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1405-28     Citation Subset:  IM    
Pain Clinic, Department of Anaesthesia and Intensive Care, Haukeland University Hospital and Department of Surgical Sciences, University of Bergen, Norway.
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MeSH Terms
Analgesics, Opioid / therapeutic use
Anesthetics, Dissociative / administration & dosage,  adverse effects,  therapeutic use*
Data Interpretation, Statistical
Drug Therapy, Combination
Ketamine / administration & dosage,  adverse effects,  therapeutic use*
Middle Aged
Pain Measurement / drug effects
Pain, Postoperative / drug therapy*
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Dissociative; 6740-88-1/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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