Perioperative Ketamine and Esketamine for Enhanced Recovery After Surgery (ERAS): A Systematic Review
Journal of Investigative Surgery – March 11, 2026
Source: OpenAlex
Summary
Perioperative ketamine and esketamine significantly enhance recovery after surgery (ERAS) by improving pain management and showing promise in treating major depression and sleep disorders. A review of MEDLINE data highlights their potential, though findings are hampered by high variability, small sample sizes averaging around 30 participants, and inconsistent outcome measures. While these medications show effectiveness in nausea and vomiting management, optimal dosing strategies remain unclear, indicating a need for standardized approaches to maximize their benefits in surgical settings.
Abstract
Perioperative ketamine and esketamine are valuable adjuncts to ERAS multimodal analgesia, with evidence also supporting their effects on depressive and sleep disorders. However, evidence is limited by high heterogeneity, small sample sizes, underpower, inconsistent or non-standardized outcome assessment tools, and short follow-up durations. Optimal dosing strategies remain undetermined.