Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
Obes Surg. 2021 Dec;31(12):5446-5457. doi: 10.1007/s11695-021-05753-8. Epub 2021 Oct 13.
This meta-analysis aimed at exploring the impact of intravenous ketamine on pain relief and analgesic consumption in patients undergoing bariatric surgery (BS). Literature searches identified nine eligible trials with 458 participants. Forest plot revealed a significantly lower pain score [mean difference (MD) = - 1.06, p = 0.005; 390 patients) and morphine consumption (MD = - 3.85 mg, p = 0.01; 212 patients) immediately after BS in patients with intravenous ketamine than in those without. In contrast, pooled analysis showed comparable pain score (p = 0.28), morphine consumption (p = 0.45) within 24 h, and risk of postoperative nausea/vomiting (p = 0.67) between the two groups. In conclusion, the meta-analysis demonstrated improvements in pain outcomes immediately after surgery through perioperative intravenous ketamine administration despite the absence of analgesic benefit in the late postoperative period and a positive impact on postoperative nausea/vomiting.
这项荟萃分析旨在探讨静脉注射氯胺酮对接受减重手术（BS）患者的疼痛缓解和镇痛药物消耗的影响。文献检索确定了九项符合条件的试验，共有 458 名参与者。森林图显示，静脉注射氯胺酮的患者术后即刻疼痛评分[均数差（MD）=-1.06，p=0.005；390 名患者]和吗啡消耗量（MD=-3.85 毫克，p=0.01；212 名患者）明显低于未接受静脉注射氯胺酮的患者。相比之下，两组患者术后 24 小时内的疼痛评分（p=0.28）、吗啡消耗量（p=0.45）具有可比性，且术后恶心/呕吐的风险（p=0.67）也无差异。综上所述，尽管术后晚期镇痛效果没有改善，但围手术期静脉注射氯胺酮可改善术后即刻的疼痛结局，并对术后恶心/呕吐产生积极影响。
