Analgesic effect of perioperative ketamine for total hip arthroplasties and total knee arthroplasties: A PRISMA-compliant meta-analysis.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(23):5 Medicine (Baltimore). 2020 Oct 16; 99(42): e22809.What this means for my practice?
Study findings suggest that perhaps peri-operative ketamine administration is an effective treatment for the reduction of post-operative pain and opioid consumption in patients undergoing total hip or knee arthroplasty. Moreover, peri-operative ketamine use may reduce the incidence of post-operative nausea and vomiting. This study was limited by the heterogeneity in treatment dose, follow up time, and procedures across the included studies. Moreover, future studies are still required to determine the ideal dose, patient population, and conditions for ketamine treatment.
Resumen del estudio
Twenty-one studies including 1145 patients undergoing total hip or knee arthroplasty were included in this meta-analysis comparing peri-operative ketamine and control for the management of post-operative pain and reduction of opioid consumption. Pooled outcomes of interest included pain on a Visual Analog Scale (VAS), opioid consumption in morphine equivalents, and the incidence of side effects (i.e., sedation, dizziness, hallucination; post-operative nausea and vomiting, sweating, pruritus, urinary retention, constipation, version trouble, nightmare, and delirium). Pooled results revealed statistically significantly lower VAS pain scores at 6 hours, 12 hours, 24 hours and 48 hours post-operation in the ketamine group compared to the control group (p<0.01 for all). Pooled opioid consumption in morphine equivalents were statistically significantly lower in the ketamine group at 24 hours (p=0.003), and 48 hours (p=0.003) post-operation. The pooled incidence of post-operative nausea and vomiting was statistically significantly lower in the ketamine group (p=0.0008); otherwise, no statistically significant differences were observed in the pooled incidence of side effects between the two groups.
Desbloquear el informe ACE completo
Tiene acceso a 4 más artículos GRATUITOS este mes.
Haga clic a continuación para desbloquear y ver este ACE Reports
Desbloquear ahora
Evaluaciones críticas de los últimos ensayos controlados aleatorizados de gran impacto y revisiones sistemáticas en ortopedia
Acceso al contenido del podcast OrthoEvidence, que incluye colaboraciones con el Journal of Bone and Joint Surgery, entrevistas con cirujanos reconocidos internacionalmente y mesas redondas sobre noticias y temas ortopédicos
Suscripción a The Pulse, un boletín quincenal basado en la evidencia y diseñado para ayudarle a tomar mejores decisiones clínicas
Acceso exclusivo a artículos de contenido original, incluidas revisiones sistemáticas propias, y artículos sobre métodos de investigación sanitaria y temas ortopédicos de actualidad
O actualícese hoy mismo y obtenga acceso a todo el contenido de OrthoEvidencepor tan sólo 1,99 $ a la semana.
¿Ya tiene una cuenta? Conectarse
¿Está afiliado a una de nuestras asociaciones colaboradoras?
¡Haga clic aquí para obtener acceso gratuito como parte de los beneficios de miembro de su asociación!
Suscríbase a "El Pulso"
Ortopedia basada en la evidencia directamente a su bandeja de entrada. SUSCRIBIRSE