Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review
Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involv...
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| Veröffentlicht in: | BioMed research international 2015-01, Vol.2015 (2015), p.1-10 |
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| creator | Le, Vanny Sifonios, Anthony N. Parikh, Anant Shah, Khushbu Radvansky, Brian M. Eloy, Jean Daniel |
| description | Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for. |
| doi_str_mv | 10.1155/2015/749837 |
| format | Article |
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The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2015/749837</identifier><identifier>PMID: 26495312</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Acute Pain - diagnosis ; Acute Pain - drug therapy ; Acute Pain - prevention & control ; Addictions ; Analgesics ; Anesthesia ; Anesthesiology ; Anesthetics, Dissociative - administration & dosage ; Binding sites ; Bone surgery ; Care and treatment ; Dosage and administration ; Dose-Response Relationship, Drug ; Drug dosages ; Evidence-Based Medicine ; Humans ; Ketamine ; Ketamine - administration & dosage ; Pain ; Pain management ; Pain Management - methods ; Pain Measurement - drug effects ; Pain, Postoperative ; Pain, Postoperative - diagnosis ; Pain, Postoperative - drug therapy ; Pain, Postoperative - prevention & control ; Patient outcomes ; Patient satisfaction ; Physiology ; Preanesthetic Medication - methods ; Prevention ; Review ; Studies ; Treatment Outcome</subject><ispartof>BioMed research international, 2015-01, Vol.2015 (2015), p.1-10</ispartof><rights>Copyright © 2015 Brian M. Radvansky et al.</rights><rights>COPYRIGHT 2015 John Wiley & Sons, Inc.</rights><rights>Copyright © 2015 Brian M. Radvansky et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2015 Brian M. Radvansky et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-703fe64e563611a603d18362acdab409ea8a3dcadc4cbca87a12c9bd14b3f8d13</citedby><cites>FETCH-LOGICAL-c528t-703fe64e563611a603d18362acdab409ea8a3dcadc4cbca87a12c9bd14b3f8d13</cites><orcidid>0000-0001-9674-2217</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606413/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606413/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,883,27907,27908,53774,53776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26495312$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Khor, Kok Eng</contributor><creatorcontrib>Le, Vanny</creatorcontrib><creatorcontrib>Sifonios, Anthony N.</creatorcontrib><creatorcontrib>Parikh, Anant</creatorcontrib><creatorcontrib>Shah, Khushbu</creatorcontrib><creatorcontrib>Radvansky, Brian M.</creatorcontrib><creatorcontrib>Eloy, Jean Daniel</creatorcontrib><title>Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Objectives. The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. 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The objective of this narrative review was to examine the usage of ketamine as a postoperative analgesic agent across a wide variety of surgeries. Design. A literature search was performed using the phrases “ketamine” and “postoperative pain.” The authors analyzed the studies that involved testing ketamine’s effectiveness at controlling postoperative pain. Effectiveness was assessed through various outcomes such as the amount of opiate consumption, visual analog scale (VAS) pain scores, and persistent postoperative pain at long-term follow-up. Results. While many different administration protocols were evaluated, delivering ketamine both as a pre- or perioperative bolus and postoperative infusion for up to 48 hours appeared to be the most effective. These effects are dose-dependent. However, a number of studies analyzed showed no benefit in using ketamine versus placebo for controlling postoperative pain. While ketamine is a safe and well-tolerated drug, it does have adverse effects, and there are concerns for possible neurotoxicity and effects on memory. Conclusions. In a number of limited situations, ketamine has shown some efficacy in controlling postoperative pain and decreasing opioid consumption. More randomized controlled trials are necessary to determine the surgical procedures and administrations (i.e., intravenous, epidural) that ketamine is best suited for.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>26495312</pmid><doi>10.1155/2015/749837</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9674-2217</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Pain - diagnosis Acute Pain - drug therapy Acute Pain - prevention & control Addictions Analgesics Anesthesia Anesthesiology Anesthetics, Dissociative - administration & dosage Binding sites Bone surgery Care and treatment Dosage and administration Dose-Response Relationship, Drug Drug dosages Evidence-Based Medicine Humans Ketamine Ketamine - administration & dosage Pain Pain management Pain Management - methods Pain Measurement - drug effects Pain, Postoperative Pain, Postoperative - diagnosis Pain, Postoperative - drug therapy Pain, Postoperative - prevention & control Patient outcomes Patient satisfaction Physiology Preanesthetic Medication - methods Prevention Review Studies Treatment Outcome |
| title | Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review |
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