Impact of intra-operative ketamine on postoperative outcomes in abdominal surgery: a narrative review.

IF 3.8 Q2 GASTROENTEROLOGY & HEPATOLOGY Translational gastroenterology and hepatology Pub Date : 2024-03-26 eCollection Date: 2024-01-01 DOI:10.21037/tgh-23-97
Daniela Kerguelen Murcia, Joy S Li, Uma R Phatak
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Abstract

Background and objective: Ketamine offers a promising solution to common postoperative issues in abdominal surgery, including pain, nausea, opioid use, and opioid-related side effects. The purpose of this literature review is to analyze the benefits and potential adverse effects associated with the intraoperative utilization of ketamine during abdominal surgeries.

Methods: A comprehensive search of PubMed and Ovid MEDLINE was conducted by two independent reviewers. Studies were included if they targeted adult patients and evaluated intra-operative use of ketamine for abdominal operations.

Key content and findings: We identified 13 studies of intraoperative use of ketamine in abdominal surgery. The results of these studies showed improved pain management as demonstrated by lower pain scores, decreased hyperalgesia, and a decreased need for additional analgesics. The results also demonstrated a decrease in opioid consumption during the critical 24-hour postoperative period. However, a few studies reported undesirable side effects such as hallucinations and delirium.

Conclusions: The intraoperative use of ketamine holds promise as a valuable adjunct to anesthesia during abdominal surgeries. Studies support its use in improving post-operative pain and decreasing opioid consumption. Due to risks of adverse effects, further studies in larger patient populations may help identify which patients will benefit the most. This review offers a succinct selection of the pertinent literature.

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术中氯胺酮对腹部手术术后效果的影响:叙述性综述。
背景和目的:氯胺酮有望解决腹部手术中常见的术后问题,包括疼痛、恶心、阿片类药物的使用以及阿片类药物相关的副作用。本文献综述旨在分析腹部手术术中使用氯胺酮的益处和潜在不良反应:方法:两位独立审稿人对 PubMed 和 Ovid MEDLINE 进行了全面检索。主要内容和结果:我们发现了 13 项关于腹部手术术中使用氯胺酮的研究:我们确定了 13 项关于腹部手术术中使用氯胺酮的研究。这些研究的结果表明,疼痛评分降低、痛觉减退以及对额外镇痛药的需求减少,表明疼痛控制得到了改善。研究结果还显示,在术后 24 小时的关键时期,阿片类药物的用量有所减少。不过,也有少数研究报告了幻觉和谵妄等不良副作用:结论:术中使用氯胺酮有望成为腹部手术麻醉的重要辅助手段。研究支持使用氯胺酮改善术后疼痛并减少阿片类药物的用量。由于存在不良反应的风险,在更大的患者群体中开展进一步研究可能有助于确定哪些患者受益最大。本综述简明扼要地选取了相关文献。
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