Evidence map›Paper›PMID 31519671›Full record

SynthesisBMJ open2019

Analgesic efficacy and safety of ketamine after total knee or hip arthroplasty: a meta-analysis of randomised placebo-controlled studies.

Bei Xu, Yilun Wang, Chao Zeng, Jie Wei, Jiatian Li, Ziying Wu, Hongyi He, Guanghua Lei, Dongxing Xie, Xiang Ding

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.1field-weighted citation impact, top 14% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Review
  7. Review
  8. Review
  9. 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

10 authors at 1 institution in 1 country.

Bei Xu *Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Yilun Wang *Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.ORCID 0000-0002-9468-4110
Chao ZengOrthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Jie WeiHealth Management Center, Xiangya Hospital, Central South University, Changsha, China.
Jiatian LiOrthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Ziying WuOrthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Hongyi HeOrthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Guanghua LeiOrthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Dongxing Xie *Orthopaedics, Xiangya Hospital, Central South University, Changsha, China xdx1024@csu.edu.cn dingxiang@csu.edu.cn.
Xiang Ding *Orthopaedics, Xiangya Hospital, Central South University, Changsha, China xdx1024@csu.edu.cn dingxiang@csu.edu.cn.
Central South University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine the analgesic efficacy and safety of ketamine after total knee or hip arthroplasty.

designSystematic review and meta-analysis. DATA SOURCES: PubMed, EMBASE and Cochrane Library from inception to 22 May 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing the efficacy and safety of ketamine with placebo for postoperative pain relief in patients undergoing total knee or hip arthroplasty. DATA EXTRACTION AND SYNTHESIS: Data (ie, pain intensity, morphine consumption, gastrointestinal and psychotic adverse effects) were extracted by two reviewers independently. The Cochrane Collaboration's recommended tool was used to determine the methodological quality of included studies.

resultsA total of 10 studies were included. One of them was rated as low quality. Compared with placebo, intravenous ketamine was effective for pain relief during 0-8-hour (weighted mean difference (WMD) -1.21, 95% CI -1.45 to -0.98, p<0.001; three studies, 149 participants) but not during 8-24-hour postoperative periods, and effective for reduction of cumulative morphine consumption during both 0-24-hour (WMD -17.76, 95% CI -31.25 to -4.27, p=0.01; five studies, 366 participants) and 0-48-hour (WMD -21.79, 95% CI -25.46 to -18.11, p<0.001; four studies, 252 participants) postoperative periods, without increasing risks of gastrointestinal or psychotic adverse effects. The limited data available for intra-articular (WMD -0.49, 95% CI -0.70 to -0.29, p<0.001; two studies, 83 participants) and epidural (WMD -2.10, 95% CI -3.30 to -0.90, p<0.001; one study, 20 participants) ketamine pointed to a significant reduction in pain intensity during 8-24-hour postoperative period.

conclusionsIntravenous administration of ketamine is effective and safe for postoperative pain relief in patients undergoing total knee or hip arthroplasty. Nevertheless, the analgesic efficacy and safety of ketamine in such patients seem to vary by different administration routes and still warrant further studies to explore.

Indexed as

AnalgesicsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHumansKetamineMorphinePain ManagementPostoperative PainRandomized Controlled Trials as TopicAnalgesicsKetamineMorphinearthroplastyketaminemeta-analysis

Identifiers

PMID31519671
PMCPMC6747636
OpenAlexW2973071171

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.