Use and efficacy of low-dose ketamine in the management of acute postoperative pain: a review of current techniques and outcomes
Pain August 1, 1999 Roger Schmid, Alan N. Sandler, Joel Katz 547 citations
Ketamine, an anesthetic and short-acting analgesic used for nearly 30 years, has renewed clinical interest as an NMDA receptor antagonist for pain management. This review of randomized, double-blind, controlled trials from 1966 to 1998 examined low-dose ketamine for acute postoperative pain, defined as a bolus less than 2 mg/kg intramuscularly or less than 1 mg/kg intravenously or epidurally, or a continuous intravenous rate of 20 µg/kg per minute or less. The evidence suggests low-dose ketamine may improve postoperative pain management and reduce opioid-related adverse effects when used as an adjunct to local anesthetics, opioids, or other analgesics. Further research is needed on dosing, optimal routes, S(+)-ketamine, long-term outcomes, stability, spinal toxicity, and cognitive effects.