Evidence map›Paper›PMID 18751864›Full record

ArticleHSS journal : the musculoskeletal journal of Hospital for Special Surgery2008

Ketamine as an adjunct to postoperative pain management in opioid tolerant patients after spinal fusions: a prospective randomized trial.

Michael K Urban, Jacques T Ya Deau, Barbara Wukovits, Jane Y Lipnitsky

2 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 40 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 7 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02682498 phase4completednot on this mapstarted 2013, after this paper: background citation

A Double Blind, Randomized Clinical Trial Comparing Postoperative Narcotic Usage in Patients Receiving Periarticular Liposomal Bupivicaine vs. Those Patients Receiving Standard Periarticular Joint Injections

TypeinterventionalSponsorUniversity of California, IrvineRan2013 to 2015Enrolled38ConditionsArthroplasty, Replacement, KneeArms(Bupivacaine Liposome Injectable Suspension), Standard Preparation
NCT04016740 early_phase1completednot on this mapstarted 2019, after this paper: background citation

Perioperative Multimodal General Anesthesia Focusing on Specific CNS Targets in Patients Undergoing Cardiac Surgeries

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2019 to 2020Enrolled22ConditionsCoronary Artery Disease, DeliriumArmsRopivacaine, Ketamine, Remifentanil, Dexmedetomidine, Rocuronium
3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 7 syntheses or guidelines pooled it, 113 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Perioperative intravenous ketamine for acute postoperative pain in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  5. Guideline
  6. Interventions for preventing delirium in hospitalised non-ICU patients.The Cochrane database of systematic reviews · 2016
    Pooled it
  7. Pooled it
  8. Trial
  9. Effects of opioids and stimulants on the respiratory system.European respiratory review : an official journal of the European Respiratory Society · 2026
    Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Review
  15. Review
  16. Observational
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Michael K UrbanDepartment of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. urbanm@hss.edu
Jacques T Ya Deau
Barbara Wukovits
Jane Y Lipnitsky
Hospital for Special Surgery · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Management of acute postoperative pain is challenging, particularly in patients with preexisting narcotic dependency. Ketamine has been used at subanesthetic doses as a N-methyl D-aspartate (NMDA) receptor antagonist to block the processing of nociceptive input in chronic pain syndromes. This prospective randomized study was designed to assess the use of ketamine as an adjunct to acute pain management in narcotic tolerant patients after spinal fusions. Twenty-six patients for 1-2 level posterior lumbar fusions with segmental instrumentation were randomly assigned to receive ketamine or act as a control. Patients in the ketamine group received 0.2 mg/kg on induction of general anesthesia and then 2 mcg kg(-1) hour(-1) for the next 24 hours. Patients were extubated in the operating room and within 15 minutes of arriving in the Post Anesthesia Care Unit (PACU) were started on intravenous patient-controlled analgesia (PCA) hydromorphone without a basal infusion. Patients were assessed for pain (numerical rating scale [NRS]), narcotic use, level of sedation, delirium, and physical therapy milestones until discharge. The ketamine group had significantly less pain during their first postoperative hour in the PACU (NRS 4.8 vs 8.7) and continued to have less pain during the first postoperative day at rest (3.6 vs 5.5) and with physical therapy (5.6 vs 8.0). Three patients in the control group failed PCA pain management and were converted to intravenous ketamine infusions when their pain scores improved. Patients in the ketamine group required less hydromorphone than the control group, but the differences were not significant. Subanesthetic doses of ketamine reduced postoperative pain in narcotic tolerant patients undergoing posterior spine fusions.

Identifiers

PMID18751864
PMCPMC2504281
OpenAlexW1984127999

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.