Evidence map›Paper›PMID 42307049›Full record

Trial reportPain research & management2026

Efficacy of Low-Dose Intravenous Ketamine With Spinal Anesthesia for Postoperative Pain Control in Total Knee Arthroplasty: A Randomized Clinical Trial.

Arash Sherafat Vaziri, Sina Javidmehr, Alireza Arvin, Arash Heroabadi, Fardis Vosoughi, Sohrab Keyhani, Maryam Salimi, Mir Saeed Yekaninejad, Hassan Zolghadr, Seyedeh Reihaneh Hosseini

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Pain research & management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Trial
  2. 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.

Arash Sherafat VaziriCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0000-0002-4139-0071
Sina JavidmehrDepartment of Orthopaedic Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0009-0004-5859-4259
Alireza ArvinCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0009-0004-7265-4756
Arash HeroabadiBrain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0000-0002-5339-1557
Fardis VosoughiDepartment of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0000-0002-9136-0479
Sohrab KeyhaniAkhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, sbmu.ac.ir.ORCID https://orcid.org/0000-0002-4455-5214
Maryam SalimiCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0000-0001-9771-7048
Mir Saeed YekaninejadDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0000-0003-3648-5276
Hassan ZolghadrCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0009-0008-5932-7266
Seyedeh Reihaneh HosseiniCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran, tums.ac.ir.ORCID https://orcid.org/0000-0002-1723-7712

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe efficacy of low-dose intravenous (IV) ketamine as an adjunct analgesic to spinal anesthesia in total knee arthroplasty (TKA) remains uncertain. This study aims to assess ketamine's impact on postoperative pain level and opioid consumption.

methodsIn a randomized, triple-blind, placebo-controlled trial conducted at Shariati Hospital, Tehran, Iran, 65 patients undergoing unilateral TKA were assigned to receive either 0.5 mg/kg IV ketamine or saline. The primary outcome was cumulative opioid consumption in the first 24 h. Secondary outcomes were visual analog scale (VAS) pain scores at 2, 6, 12, and 24 h and at 2 and 6 weeks, knee range of motion at discharge, operative time, length of stay, and adverse effects.

resultsMedian 0- to 24-h opioid use was similar (ketamine 10 [range 10-17.5] vs. placebo 10 [range 10-15] morphine milligram equivalents [MME]; p = 1.00). VAS scores were numerically lower with ketamine at all time points, but no comparison remained significant after adjustment for multiple comparisons, and there was no time × treatment interaction. No significant differences were observed in other secondary outcomes, including knee flexion and extension, operative time, and length of stay. Side effects were minimal and comparable between groups.

conclusionsLow-dose IV ketamine shows no measurable analgesic benefits in the long term, and it does not significantly reduce pain or opioid use after TKA within a multimodal pain protocol. Further research is needed to explore various analgesia strategies and follow-up durations to optimize pain management.

trial registrationIranian Registry of Clinical Trials: IRCT20220315054298N1.

Indexed as

AnalgesicsAnesthesia, SpinalArthroplasty, Replacement, KneeKetaminePostoperative PainAgedAnalgesics, OpioidDouble-Blind MethodFemaleHumansMaleMiddle AgedPain MeasurementTreatment OutcomeAnalgesicsAnalgesics, OpioidKetamineketaminepostoperative painspinal anesthesiatotal knee arthroplasty

Identifiers

PMID42307049
PMCPMC13273836

What OpenQuestion holds

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LicenceCC BY
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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.