Continuous ketamine infusion for surgical patients in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials with GRADE assessment
Pooled result · Opioid consumption at 24 h in adultsResult — go to the resultMD - 5.77 mg morphine equivalents 95% CI - 6.32 to - 5.23Authors' conclusion
In postoperative surgical ICU patients, continuous low-dose ketamine infusion provides modest opioid sparing and is associated with lower PONV, without clear improvements in pain scores or ICU recovery outcomes.
Study context
- Population
- Postoperative patients admitted to the surgical intensive care unit (ICU)
- Participants
- 666 patients · 9 randomized controlled trials (RCTs)
- Comparison
- Ketamine vs Non-ketamine
- Outcome
- Cumulative opioid consumption (IV morphine equivalents where applicable) and rest pain intensity at prespecified early postoperative timepoints
- Follow-up
- First 24-48 h
Methodological detailsrandom-effects, GRADE assessment
- Random-effects
- GRADE assessment
Pooled result
Opioid consumption at 24 h in adults
MD
- 5.77 mg morphine equivalents
95% CI - 6.32 to - 5.23
P < 0.0001
As reported in the abstract
Further pooled results
| Outcome | MD (h) (95% CI) |
|---|---|
| Mechanical ventilation time | - 0.84 (- 1.93 to 0.24) |
| ICU LOS | - 0.97 (- 1.95 to 0.02) |
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| PONV | 0.59 (0.36–0.98) | P = 0.0399 | |
| 0.20.5125Relative risk (log scale) |
Psychotomimetic adverse events
- Infrequent and not significantly increased
Original publication
Continuous ketamine infusion for surgical patients in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials with GRADE assessment. Crit Care. Published 23 January 2026. doi:10.
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