Efficacy and safety of ketamine as an adjuvant to regional anesthesia: A systematic review and meta-analysis of randomized controlled trials
Pooled result · Duration of analgesiaResult — go to the resultMD 172.21 min 95% CI 118.20–226.22Authors' conclusion
This study indicates that ketamine could be an ideal adjuvant to local anesthetics regardless of the types of anesthesia. Overall, the quality of the evidence is low.
Study context
- Population
- ASA I–II patients undergoing surgery or procedures under regional anesthesia, with or without GA
- Participants
- 1,011 patients · 20 RCTs
- Comparison
- Ketamine added to local anaesthetic in RA vs no ketamine
- Outcome
- Duration of analgesia
Methodological detailsCochrane risk of bias tool, Grading of Recommendations, Assessment, Development and Evaluations (GRADE), Overall quality of evidence low (GRADE)
- Cochrane risk of bias tool
- GRADE
- Overall quality of evidence low (GRADE)
Pooled result
As reported in the abstract
MD
172.21 min
95% CI 118.20–226.22
P < 0.00001
Ketamine vs No ketamine
MD 172.21 min (95% CI 118.20–226.22); P < 0.00001
Further pooled results
| Outcome | MD (min) (95% CI) | P value | |
|---|---|---|---|
| Duration of analgesia, peripheral nerve block (subgroup)I2 = 98% | 366.96 (154.19–579.74) | P = 0.0007 | |
| Duration of sensory blockI2 = 96% | 29.12 (10.22–48.01) | P = 0.003 | |
| Duration of motor blockI2 = 84% | 6.94 (−2.65 to 16.53) | P = 0.16 | |
| Motor block onset timeI2 = 100% | −1.17 (−2.67 to 0.34) | P = 0.13 | |
| Sensory block onset timeI2 = 96% | −0.33 (−0.87 to 0.20) | P = 0.23 | |
| −50005001000Difference, min (linear scale) |
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Ketamine-related adverse effectsI2 = 57% | 1.97 (0.93–4.17) | P = 0.08 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Efficacy and safety of ketamine as an adjuvant to regional anesthesia: A systematic review and meta-analysis of randomized controlled trials. J Clin Anesth. Published 23 February 2024. doi:10.
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