Abstract | OBJECTIVE: DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, EMBASE and Cochrane Library from inception to 22 May 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: DATA EXTRACTION AND SYNTHESIS: Data (ie, pain intensity, morphine consumption, gastrointestinal and psychotic adverse effects) were extracted by two reviewers independently. The Cochrane Collaboration's recommended tool was used to determine the methodological quality of included studies. RESULTS: A total of 10 studies were included. One of them was rated as low quality. Compared with placebo, intravenous ketamine was effective for pain relief during 0-8-hour (weighted mean difference (WMD) -1.21, 95% CI -1.45 to -0.98, p<0.001; three studies, 149 participants) but not during 8-24-hour postoperative periods, and effective for reduction of cumulative morphine consumption during both 0-24-hour (WMD -17.76, 95% CI -31.25 to -4.27, p=0.01; five studies, 366 participants) and 0-48-hour (WMD -21.79, 95% CI -25.46 to -18.11, p<0.001; four studies, 252 participants) postoperative periods, without increasing risks of gastrointestinal or psychotic adverse effects. The limited data available for intra-articular (WMD -0.49, 95% CI -0.70 to -0.29, p<0.001; two studies, 83 participants) and epidural (WMD -2.10, 95% CI -3.30 to -0.90, p<0.001; one study, 20 participants) ketamine pointed to a significant reduction in pain intensity during 8-24-hour postoperative period. CONCLUSIONS:
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Authors | Bei Xu, Yilun Wang, Chao Zeng, Jie Wei, Jiatian Li, Ziying Wu, Hongyi He, Guanghua Lei, Dongxing Xie, Xiang Ding |
Journal | BMJ open
(BMJ Open)
Vol. 9
Issue 9
Pg. e028337
(09 13 2019)
ISSN: 2044-6055 [Electronic] England |
PMID | 31519671
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)
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Copyright | © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
- Analgesics
- Ketamine
- Morphine
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Topics |
- Analgesics
(therapeutic use)
- Arthroplasty, Replacement, Hip
(adverse effects)
- Arthroplasty, Replacement, Knee
(adverse effects)
- Humans
- Ketamine
(therapeutic use)
- Morphine
(administration & dosage)
- Pain Management
- Pain, Postoperative
(prevention & control)
- Randomized Controlled Trials as Topic
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