Perioperative ketamine for analgesia in spine surgery: a meta-analysis of randomized controlled trials

Literature suggested that low dose of Ketamine has been used as an analgesic after surgery. But there are conflicting results regarding whether Ketamine can be alternative to opioid following spine surgery. Therefore this meta-analysis indicated that supplemental perioperative Ketamine reduces postoperative opioid consumption up to 24 hours following spine surgery.  

The low-dose supplemental Ketamine is known for its efficiency to lessen pain following the surgery, but the evidence regarding Ketamine can be efficient in decreasing opioid intake after the spine surgery is incongruous, and this study is conducted to find relating evidence.

The Web of Science, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched prospectively to found the proper RCTs. A comparison was done between the supplemental Ketamine and control groups for calculating postoperative pain scores, adverse events, and morphine equivalent expenditure. The sustained outcomes of the analysis were reported using mean differences (MDs) and 95% confidence intervals (Cis) and dichotomous outcomes using odds ratios (ORs) and 95% Cis.

Fourteen RCTs including 649 subjects were short-listed. Lower cumulative morphine equivalent intake and postoperative pain scores noticed at 4, 8, 12, and 24 hours after the spine surgery by the patients who took adjunctive Ketamine. No established statistical significance was notified regarding adverse events.

The postoperative and pain reduces using the supplemental perioperative Ketamine up to 24 hours after the spine surgery.