Scholarlink

<p>Post-thyroidectomy pain is a clinically significant issue that may adversely impact postoperative recovery and patient comfort. The use of ketamine/esketamine infusions has emerged as a promising strategy to reduce postoperative pain and minimize the associated need for additional analgesic consumption.We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, Google Scholar, CENTRAL, Scopus, and Web of Science through February 2025. The primary outcome was postoperative pain intensity. Secondary outcomes included the need for rescue analgesia, duration of surgery, extubation time, and the incidence of adverse events, including postoperative nausea and vomiting (PONV), dizziness, hallucinations, and headache. Dichotomous outcomes were pooled using relative risk (RR), while continuous outcomes were analyzed using standardized mean difference (SMD) or mean difference (MD), each with a 95% confidence interval (CI).A total of six RCTs comprising 443 patients were included. Ketamine/esketamine significantly reduced postoperative pain at 1–2 h (SMD = –1.02; 95% CI: –1.31, –0.73; <i>p</i> &lt; 0.001), 6–8 h (SMD = –0.76; 95% CI: –1.04, –0.47; <i>p</i> = 0.001), and 12 h (SMD = –0.82; 95% CI: –1.16, –0.47; <i>p</i> = 0.001). However, no significant difference was observed at 24 h (SMD = –0.36; 95% CI: –0.79, 0.07; <i>p</i> = 0.40). Ketamine/esketamine also significantly reduced the risk of requiring rescue analgesia (RR = 0.49; 95% CI: 0.30, 0.83; <i>p</i> = 0.01). Conversely, its use was associated with a significantly prolonged extubation time (MD = 1.75 min; 95% CI: 0.48, 3.02; <i>p</i> = 0.01). No significant differences were observed in the incidence of postoperative nausea and vomiting (<i>p</i> = 0.93), hallucinations (<i>p</i> = 0.41), dizziness (<i>p</i> = 0.93), or headache (<i>p</i> = 0.73).Ketamine/Esketamine infusion significantly reduced postoperative pain within the first 12 h following thyroidectomy and lowered the need for rescue analgesia. It was generally well-tolerated, with no increase in the incidence of PONV, hallucinations, dizziness, or headache compared to control. However, it had no impact on intraoperative opioid or propofol consumption and was associated with a slight prolongation in extubation time (approximately two minutes).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Analgesic Efficacy of Ketamine/Esketamine Infusion Following Thyroidectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • 期刊论文

  • 发表日期：

    2025年6月20日

查看全文
  • Ebraheem Albazee,
  • Latifah Almutairi,
  • Abdullatif Abdulrahim,
  • Abdulrahman Makhseed,
  • Mohammed M. Mehanna

摘要

Post-thyroidectomy pain is a clinically significant issue that may adversely impact postoperative recovery and patient comfort. The use of ketamine/esketamine infusions has emerged as a promising strategy to reduce postoperative pain and minimize the associated need for additional analgesic consumption.We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, Google Scholar, CENTRAL, Scopus, and Web of Science through February 2025. The primary outcome was postoperative pain intensity. Secondary outcomes included the need for rescue analgesia, duration of surgery, extubation time, and the incidence of adverse events, including postoperative nausea and vomiting (PONV), dizziness, hallucinations, and headache. Dichotomous outcomes were pooled using relative risk (RR), while continuous outcomes were analyzed using standardized mean difference (SMD) or mean difference (MD), each with a 95% confidence interval (CI).A total of six RCTs comprising 443 patients were included. Ketamine/esketamine significantly reduced postoperative pain at 1–2 h (SMD = –1.02; 95% CI: –1.31, –0.73; p < 0.001), 6–8 h (SMD = –0.76; 95% CI: –1.04, –0.47; p = 0.001), and 12 h (SMD = –0.82; 95% CI: –1.16, –0.47; p = 0.001). However, no significant difference was observed at 24 h (SMD = –0.36; 95% CI: –0.79, 0.07; p = 0.40). Ketamine/esketamine also significantly reduced the risk of requiring rescue analgesia (RR = 0.49; 95% CI: 0.30, 0.83; p = 0.01). Conversely, its use was associated with a significantly prolonged extubation time (MD = 1.75 min; 95% CI: 0.48, 3.02; p = 0.01). No significant differences were observed in the incidence of postoperative nausea and vomiting (p = 0.93), hallucinations (p = 0.41), dizziness (p = 0.93), or headache (p = 0.73).Ketamine/Esketamine infusion significantly reduced postoperative pain within the first 12 h following thyroidectomy and lowered the need for rescue analgesia. It was generally well-tolerated, with no increase in the incidence of PONV, hallucinations, dizziness, or headache compared to control. However, it had no impact on intraoperative opioid or propofol consumption and was associated with a slight prolongation in extubation time (approximately two minutes).