ReviewCureus2025
Efficacy and Safety of the Ketamine-Dexmedetomidine Combination in Adult Sedation and Anesthesia: A Systematic Review and Single-Arm Meta-Analysis of Randomized Controlled Trials.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 1 paper.
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.
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.
Effect of Perioperative Use of Dexmedetomidine-esketamine Combination on Incidence of Moderate-to-severe Pain After Spinal Surgery: a Randomized Controlled Trial
Effect of Perioperative Use of Dexmedetomidine-esketamine Combination on Incidence of Chronic Postsurgical Pain After Spinal Surgery: a Randomized Controlled Trial
Perioperative Use of Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery: a 2×2 Factorial Trial
Long-term Follow-up of Perioperative Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery
Who cites it
1 citing paper in PubMed.
- A circuit dissection of perception-action decoupling in S-ketamine-induced hallucination-like states.Molecular psychiatry · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesKetodex (KD) combines ketamine's NMDA antagonism and sympathomimetic effects with dexmedetomidine's selective α₂-agonism, offering synergistic sedation, analgesia, and hemodynamic stability while limiting drug-specific drawbacks. This study aimed to describe the efficacy and safety profile of KD for adult sedation and anesthesia through a single-arm meta-analysis approach.
methodsPubMed, Cochrane Library, ScienceDirect, and Web of Science were searched for randomized controlled trials (RCTs) of KD in adults. Eligible studies reported safety or efficacy outcomes. Only the KD treatment arms were quantitatively pooled. Data on analgesia, recovery, satisfaction, and adverse events were pooled with random-effects models; heterogeneity was assessed by I².
resultsTwenty RCTs (874 participants) were included. Analgesia was consistent (mean visual analog score ≤2 for two to 12 hours). Recovery was rapid (mean 15 minutes) with a 40-minute post-anesthesia stay. Patient satisfaction reached 71-88%; physician satisfaction was 41% excellent and 54% adequate. Hemodynamics remained stable (mean arterial pressure 86.7 mmHg; heart rate 80 bpm; SpO₂ 98%). Adverse events varied: bradycardia occurred in 9% (95% CI 4-20%) but rose to 38% in breast cancer surgery. Hypotension affected 10% (95% CI 6-16%). Oxygen desaturation was usually 5-12% but reached 55% during painful emergency procedures (I² 61%). Post-operative nausea/vomiting affected 17% overall, exceeding 40% in abdominal or obstetric surgery. Neuropsychiatric effects hallucinations (7%), agitation (6%), nightmares (5%), and involuntary movements (15%) were more frequent in urgent cases.
conclusionsIn this single-arm synthesis, KD provides effective sedation and analgesia with stable vital signs and high satisfaction. Nonetheless, bradycardia, desaturation, and nausea remain clinically relevant and procedure-dependent, requiring careful patient selection and vigilant monitoring.
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What OpenQuestion holds
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.