A meta-analysis of 12 randomized controlled trials involving 805 intensive care unit patients found that ketamine was not superior to other agents for mortality, pain, opioid or midazolam consumption, or length of stay. The analysis favored ketamine for reducing delirium rates, but this finding was not robust in sequential analysis, indicating that more trials are needed.
Adding ketamine to morphine after thoracotomy reduces acute pain and lowers opioid use. A meta-analysis of nine randomized controlled trials with 556 patients found that patients receiving ketamine plus morphine had significantly less pain at rest and when moving or coughing during the first few days after surgery, and they consumed less morphine overall. The analysis found no data on whether ketamine prevents chronic pain after thoracotomy. The authors call for larger, standardized trials to assess both short- and long-term effects.