Meta-analysis of the efficacy of ketamine in postoperative pain control in adolescent idiopathic scoliosis patients undergoing spinal fusion
Gonzalo Mariscal, Jorge Morales, Silvia Pérez, Pedro Antonio Rubio-Belmar, Miquel Bovea-Marco, Jose Luis Bas, Paloma Bas, Teresa Bas
October 2022, pp 1 - 8 Review Article Read Full Article 10.1007/s00586-022-07422-5
First Online: 17 October 2022
In this meta-analysis, we aim to compare ketamine use versus a control group (saline solution) during induction of anesthesia in adolescent idiopathic scoliosis patients undergoing fusion surgery in terms of postoperative opioid consumption, pain control, and side effects.
A PubMed search of studies published over the last 20 years using the descriptor/terms “ketamine AND scoliosis” was performed. Baseline characteristics of each article were obtained and efficacy measures analyzed (morphine equivalent treatment at 24, 48, and 72 h postoperatively, complications (vomiting/nausea and pruritus), length of hospital stay (days); and pain score (VAS)) (Review Manager 5.4 software package).
Five randomized clinical trials were included. Morphine administration showed statistically significant differences at 24 and 48 h (MD − 0.15, 95% CI − 0.18 to − 0.12) and (MD − 0.26, 95% CI − 0.31 to − 0.21) between the ketamine and control (saline solution), respectively. No intergroup differences were found regarding nausea/vomiting and pruritus (OR 0.77, 95% CI 0.35 to 1.67) and (OR 0.71, 95% CI 0.31 to 1.62), respectively, same as for the pain score (MD − 0.75, 95% CI − 1.71 to 0.20).
The use intraoperative and postoperative continuous low doses of ketamine significantly reduces opioid use throughout the first 48 h in patients with AIS who undergo posterior spinal fusion.
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