Effects of Ketamine on Postoperative Pain After Remifentanil-Based Anesthesia for Major and Minor Surgery in Adults: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology
Juan F García-HenaresEsperanza Del Pozo

Abstract

Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has been postulated as an adjuvant analgesic for preventing remifentanil-induced hyperalgesia after surgery. This systematic review and meta-analysis aims to assess the effectiveness of ketamine [racemic mixture and S-(+)-ketamine] in reducing morphine consumption and pain intensity scores after remifentanil-based general anesthesia. We performed a literature search of the PubMed, Web of Science, Scopus, Cochrane, and EMBASE databases in June 2017 and selected randomized controlled trials using predefined inclusion and exclusion criteria. To minimize confounding and heterogeneity, studies of NMDA receptor antagonists other than ketamine were excluded and the selected studies were grouped into those assessing minor or major surgery. Methodological quality was evaluated with the PEDro and JADA scales. The data were extracted and meta-analyses were performed where possible. Twelve RCTs involving 156 adults who underwent minor surgery and 413 adults who underwent major surgery were included in the meta-analysis. When used as an adjuvant to morphine, ketamine reduced postoperative morphine consumption in the first 24 h and postoperative pain intensity in the first 2 h in ...Continue Reading

References

Jul 8, 1999·Proceedings of the National Academy of Sciences of the United States of America·D J MayerD D Price
Sep 30, 1999·Controlled Clinical Trials·H D ClarkA Laupacis
Oct 6, 2000·Anesthesiology·F M Perkins, H Kehlet
Jan 12, 2001·Physiological Reviews·J T WilliamsO Manzoni
Jun 16, 2004·Acta Anaesthesiologica Scandinavica·A C Van ElstraeteB Polin
Oct 27, 2004·Anesthesia and Analgesia·Rebecca K F KwokTony Gin
Mar 30, 2005·Biopolymers·Michael H OssipovFrank Porreca
Feb 28, 2006·Current Pain and Headache Reports·Jianren Mao
Mar 2, 2006·Anesthesiology·Martin S Angst, J David Clark
May 22, 2007·Anesthesia and Analgesia·Boris SinglerWolfgang Koppert
Jun 25, 2008·The Clinical Journal of Pain·Larry F ChuDavid Clark
Jul 9, 2010·Anesthesiology·Oliver BandschappWilhelm Ruppen
Jul 24, 2010·International Journal of Clinical Pharmacology and Therapeutics·B A HadiR Zelkó
Apr 12, 2013·CNS Neuroscience & Therapeutics·Georges Mion, Thierry Villevieille
Aug 21, 2013·Saudi Pharmaceutical Journal : SPJ : the Official Publication of the Saudi Pharmaceutical Society·Bushra A HadiRomána Zelkó
May 16, 2014·British Journal of Anaesthesia·D Fletcher, V Martinez
Apr 2, 2015·American Journal of Therapeutics·Sang Hun KimSergio D Bergese
Apr 26, 2015·Journal of Clinical Anesthesia·Plínio C LealRioko K Sakata
Jul 3, 2015·The Cochrane Database of Systematic Reviews·Rae F BellEija A Kalso
Aug 5, 2015·European Journal of Anaesthesiology·Dominique FletcherUNKNOWN euCPSP group for the Clinical Trial Network group of the European Society of Anaesthesiology
Oct 27, 2015·Korean journal of anesthesiology·Eunji ChoiHee-Jung Baik
Nov 29, 2015·The Medical Clinics of North America·John-Paul J PozekEugene R Viscusi
Dec 2, 2015·Anaesthesia·D Reddi
Oct 27, 2016·Neuroscience·Laurie-Anne RoeckelFrédéric Simonin

❮ Previous
Next ❯

Citations

Aug 17, 2019·Expert Opinion on Pharmacotherapy·Gabi KollerMichael Soyka
Nov 6, 2020·Pain Practice : the Official Journal of World Institute of Pain·Yaodan BiBin Liu

❮ Previous
Next ❯

Methods Mentioned

BETA
PCA
hysterectomy
sedation

Software Mentioned

EPIDAT
PEDro
Jadad

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.