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Meta-analysis of the efficacy of ketamine in postoperative pain control in adolescent idiopathic scoliosis patients undergoing spinal fusion

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Abstract

Purpose

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.

Methods

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).

Results

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).

Conclusions

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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Authors and Affiliations

  1. Spine Unit, Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital of Valencia, Avinguda de Fernando Abril Martorell, 106, 46026, Valencia, València, Spain

    Gonzalo Mariscal, Jorge Morales, Silvia Pérez, Pedro Antonio Rubio-Belmar, Miquel Bovea-Marco, Jose Luis Bas, Paloma Bas & Teresa Bas

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  1. Gonzalo Mariscal
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Mariscal, G., Morales, J., Pérez, S. et al. Meta-analysis of the efficacy of ketamine in postoperative pain control in adolescent idiopathic scoliosis patients undergoing spinal fusion. Eur Spine J 31, 3492–3499 (2022). https://doi.org/10.1007/s00586-022-07422-5

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