Efficiency and safety of ketamine for pain relief after laparoscopic cholecystectomy: A meta-analysis from randomized controlled trials

Int J Surg. 2018 Jan:49:1-9. doi: 10.1016/j.ijsu.2017.11.031. Epub 2017 Nov 23.

Abstract

Objective: This meta-analysis aims to evaluate the effectiveness of intravenous infusion of ketamine for pain control after laparoscopic cholecystectomy (LC).

Methods: A systematic search was performed in PubMed (1966-2017.08), Medline (1966-2017.08), Embase (1980-2017.08), ScienceDirect (1985-2017.08) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Meta-analysis was performed using Stata 11.0 software.

Results: A total of six RCTs were retrieved involving 294 patients. The present meta-analysis showed that there were significant differences between groups in terms of visual analogue scale scores at 12 h (WMD = -0.478, 95% CI: -0.934 to -0.021, P = 0.040), 24 h (WMD = -0.550, 95% CI: -1.099 to -0.002, P = 0.049), and 48 h (WMD = -0.350, 95% CI: -0.678 to -0.021, P = 0.037) after LC. Significant differences were found regarding opioid consumption at 12 h (WMD = -2.820, 95% CI: -5.170 to -0.470, P = 0.019), 24 h (WMD = -3.816, 95% CI: -7.155 to -0.478, P = 0.025), and 48 h (WMD = -2.210, 95% CI: -4.046 to -0.375, P = 0.018) after LC.

Conclusion: Intravenous ketamine infusion significantly reduced postoperative pain scores and opioid consumption after LC. In addition, there were fewer adverse effects in the ketamine groups. Higher quality RCTs are still required for further research.

Keywords: Ketamine; Laparoscopic cholecystectomy; Meta-analysis; Pain management.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Analgesics / administration & dosage*
  • Cholecystectomy, Laparoscopic / adverse effects*
  • Female
  • Humans
  • Ketamine / administration & dosage*
  • Male
  • Middle Aged
  • Pain Management
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Analgesics
  • Ketamine