In this issue of the Scandinavian Journal of Pain, Klatt and coworkers at the Clinical Trial Unit of the University Hospital in Basel, Switzerland, publish a systematic review of randomized controlled trials (RCT) on ketamine administered in the perioperative period and its possible preventive effect on persistent postoperative pain (PPP) . They were able to find 10 randomized controlled trials (RCTs) involving 784 patients. Only three of the 10 trials had some positive outcome, and only one of those three RCTs documented a statistically significant reduction of PPP. One month after surgery there was a marginal reduction of postoperative pain after ketamine. Thus, they concluded that there is no convincing evidence for the preventive effect of ketamine on new persistent pain after surgery .1Ketamine has antihyperalgesic effectsHowever, it is naïve to think that a short exposure of ketamine during surgery and for a brief period after surgery could stop CNS-reactions to the intense bombardment of the spinal cord and higher CNS systems by nociceptive impulses from a major surgical trauma . We were acutely aware of this important aspect of acute postoperative pain when Stubhaug and co-workers planned the subsequently much cited study of ketamine by IV infusion for
Scandinavian Journal of Pain – de Gruyter
Published: Apr 1, 2015
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