Evidence map›Paper›PMID 36247824›Full record

ArticleJournal of pain research2022

Adverse Effects Associated with Patient-Controlled Analgesia with Ketamine Combined with Opioids and Ketamine Infusion with PCA Bolus in Postoperative Spine Patients: A Retrospective Review.

Tiffany M Pouldar, Dermot P Maher, Alexander W Betz, Jeffrey J Wiegers, Jeremy A Friedman, Sameer S Zaidi, Ali Rejali, Hai P Tran, Roya Yumul, Charles Louy

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

Article in Journal of pain research, 2022. 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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 36% 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.

NCT06021717 phase4completednot on this map

PCA Ketamine-Morphine Versus PCA Morphine as Post-Operative Analgesia in Colorectal Surgery

TypeinterventionalSponsorUniversiti Kebangsaan Malaysia Medical CentreRan2018 to 2019Enrolled60ConditionsKetamine, MorphineArmsKetamine-Morphine, Morphine
NCT07059429 nacompletednot on this mapstarted 2025, after this paper: background citation

Randomized Controlled Study of Ketamine Administration for Postoperative Pain Management in Patients Undergoing Knee Arthroplasty,

TypeinterventionalSponsorState Budgetary Healthcare Institution, National Medical Surgical Center N.A. N.I. Pirogov, Ministry of Health of RussiaRan2025 to 2026Enrolled100ConditionsKnee Arthroplasty, Postoperative Pain, Pain Management, AnalgesiaArmsKetamine, Standard Analgesia
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Patient-Controlled Analgesia in ICU: A Scoping Review.Journal of personalized medicine · 2026
    Review
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 2 institutions in 1 country.

Tiffany M PouldarDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Dermot P MaherDepartment of Anesthesiology and Critical Care Medicine, Pain Medicine Division, Johns Hopkins Hospital, Baltimore, MD, 21205, USA.
Alexander W BetzDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Jeffrey J WiegersDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Jeremy A FriedmanDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Sameer S ZaidiDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Ali RejaliDepartment of Pharmacy, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Hai P TranDepartment of Pharmacy, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Roya YumulDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Charles LouyDepartment of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Cedars-Sinai Medical Center · USJohns Hopkins Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: There has been increasing use of ketamine at subanesthetic doses as an adjunct to opioids in perioperative pain management. There are several known adverse drug effects (ADEs) associated with ketamine. However, the incidence of ADEs with ketamine infusions with patient-controlled analgesia (PCA) boluses compared with combined opioid and ketamine PCAs is not well described. The objectives of this study were to compare the incidence and type of ADEs in postoperative spine surgery patients on ketamine infusions with as-needed PCA boluses to patients on combined opioid and ketamine PCAs. Methods: The medical records of patients who underwent spine surgery between March 2016 and March 2020 who were postoperatively treated with a ketamine infusion and as-needed PCA boluses and parenteral opioids or treated with a combined opioid and ketamine PCA were reviewed. Perioperative information including patient characteristics and preoperative morphine equivalent daily dose (MEDD) were collected. Patient charts were reviewed for ADEs including psychological and neurological side effects, nausea, and new-onset tachycardia. Results: A total of 315 patients met the inclusion criteria and were included in the final analysis. Of these patients, 121 experienced at least one ADE (38%). Sixteen of the 68 ketamine infusion with PCA bolus patients (24%), 77 of the 203 hydromorphone and ketamine patients (38%), and 28 of the 44 morphine and ketamine patients (64%) experienced an ADE [p<0.01]. In patients with preoperative MEDD ≤ 90, nausea was the only ADE that differed significantly among the three groups. Conclusion: This retrospective analysis suggests that postoperative spine patients treated with a ketamine infusion with as-needed PCA boluses and parenteral opioids were associated with fewer ADEs when compared to an intravenous combined opioid and ketamine PCA. In patients with preoperative MEDD ≤ 90, nausea with and without emesis was the only ADE that showed statistically significant difference amongst the three groups.

Indexed as

adverse drug effectsketamineopioidpatient-controlled analgesiapostoperativeretrospective

Identifiers

PMID36247824
PMCPMC9562845
OpenAlexW4303969461

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.