ICU sedation, delirium & recovery
Effect of Low-Dose Ketamine Infusion in the Intensive Care Unit on Postoperative Opioid Consumption and Traumatic Memories After Hospital Discharge: A Randomized Controlled Trial
Primary result · 24-hour fentanyl consumptionResult — go to the resultDifference −68 µg 95% CI −67 to −69Authors' conclusion
Low-dose ketamine is associated with a small but statistically significant reduction (15%) of postoperative opioid consumption in the ICU. Our secondary study revealed that patients who received low-dose ketamine during fentanyl-based postoperative pain therapy in the ICU recalled more frightening and delusional memories after ICU discharge.
Study context
- Population
- Adults admitted to a university surgical intensive care unit (ICU) after noncardiac, nonneuro, nontrauma surgery, March 2019–May 2021
- Participants
- 118 adults
- Comparison
- Low-dose ketamine 1.5 µg/kg/min vs placebo in the ICU
- Ketaminen = 60
- Placebon = 58reference
- Primary endpoint
- Fentanyl consumption
- Follow-up
- 24 hours
Methodological detailsdouble-blind, single-centre
- Double-blind
- Single-centre
Primary result
24-hour fentanyl consumption
Difference
−68 µg
95% CI −67 to −69
P = 0.041
By group
As reported in the abstract
Further findings
| Outcome | Difference (µg) (95% CI) | P value | |
|---|---|---|---|
| 24-hour fentanyl consumption, intraabdominal surgery (subgroup)Exploratory effect modification analysis | −177 (−204 to −149) | P = 0.001 | |
| −300−200−1000100Difference, µg (linear scale) |
Frightening and delusional memories of critical illness and ICU treatment (PTSD questionnaire, telephone) · 43 ± 8 months after ICU discharge
P = 0.035
- 24-hour fentanyl consumption, intraabdominal surgery (subgroup): P -for-interaction = 0.012
- Frightening and delusional memories of critical illness and ICU treatment (posttraumatic stress disorder (PTSD) questionnaire, telephone): secondary study; follow-up data for 45 patients (22 ketamine, 23 control)
RASS and NRS scores
- RASS and NRS scores did not differ between the 2 groups
Safety
- No acute adverse effects of ketamine were observed
Original publication
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