Ketamine fails in surgical recovery trial

Editor's Note
Ketamine tested for pain relief in a large, placebo-controlled, randomized trial posed side effects and did not support patient recovery after major surgery, according to findings published in the British Journal of Anesthesia and discussed in a December 3 news story from Vanderbilt University Medical Center.

Ketamine has been used as an alternative to opioids for pain relief as part of enhanced recovery after surgery (ERAS) protocols. It has demonstrated pain-relieving properties that block specific receptors in the nervous system. However, findings from this trial suggest ketamine is not beneficial in the postoperative period.

In this trial, 1,522 adults undergoing abdominal surgery were randomly assigned to receive either ketamine or saline placebo at the start of general anesthesia, followed by an infusion of these same substances during and after surgery for up to 48 hours.

Ketamine didn’t reduce opioid use or shorten hospital stays, per the article. In contrast, patients receiving ketamine were twice as likely to be transferred to intensive care, six times as likely to experience severe dizziness, more than two-and-a-half times as likely to have severe hallucinations, and twice as likely to have other severe side effects. The investigators suggested that ketamine may not be a good choice for expediting recovery after surgery.