Intraoperative low-dose ketamine for postoperative pain outcomes in opioid-naïve patients: A systematic review and meta-analysis
Authors' conclusion
In opioid-naïve patients, intraoperative low-dose ketamine may provide analgesic benefit mainly in the early postoperative period, although the clinical benefit at 24 h appears limited. Its opioid-sparing effect does not appear sustained at 48 h.
Study context
- Population
- Opioid-naïve surgical patients
- Participants
- 1,339 patients · 18 RCTs
- Comparison
- Intraoperative low-dose ketamine vs placebo
- Outcome
- Resting postoperative pain scores
Methodological detailspre-registered, RoB 2 risk of bias, GRADE certainty of evidence
- Pre-registered
- RoB 2 risk of bias
- GRADE certainty of evidence
Pooled result
As reported in the abstract
Resting pain scores
SMD
−1.51
95% CI - 2.25 to −0.77
1 h; GRADE: low
SMD
−0.92
95% CI - 1.51 to −0.23
6 h; GRADE: very low
SMD
−0.62
95% CI - 0.92 to −0.31
24 h; GRADE: low
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Need for rescue analgesiaGRADE: moderate | 0.31 (0.23–0.41) | |
| 0.20.5125Relative risk (log scale) |
| Outcome | SMD (95% CI) |
|---|---|
| Opioid consumption · 24 hGRADE: low | −1.69 (- 3.22 to −0.15) |
| Opioid consumption · 48 hGRADE: very low | −0.19 (- 0.46 to 0.07) |
Original publication
Intraoperative low-dose ketamine for postoperative pain outcomes in opioid-naïve patients: A systematic review and meta-analysis. Anaesth Crit Care Pain Med. Published 28 May 2026. doi:10.
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