Authors
Dhruv Jain, Sana Yasmin Hussain, Shailendra Kumar, Heena Garg
Published in
Asian journal of anesthesiology. Volume 63. Issue 2. Pages 44-60. Jun 01, 2025.
Abstract
Ketamine is an N-methyl-D-aspartate antagonist which possesses anti-nociceptive and local anesthetic properties. The aim of the meta-analysis is to assess the analgesic efficacy of perineural ketamine as an adjuvant to local anesthetics for regional nerve blocks. Randomized controlled trials (RCTs) comparing ketamine as an adjuvant to local anesthetic solution in regional nerve blocks in adult patients undergoing elective surgeries were systematically searched from databases-PubMed, Embase, CENTRAL from inception till June 2024. The primary objective was the duration of analgesia. Secondary objectives included postoperative opioid requirement, onset and duration of nerve block, and complications. A total of 25 RCTs (1,178 patients) were included. Duration of analgesia was significantly longer (mean difference [MD], 142.86 minutes; 95% confidence interval [CI], [107.75, 177.97]; P < 0.001) and opioid requirement was lower (standardized mean difference [SMD], -1.42; 95% CI, [-1.95, -0.89; P < 0.0001) when ketamine was used as an adjuvant for regional nerve blocks. Duration of sensory block was prolonged significantly in the ketamine group (MD, -15.07 minutes; 95% CI, [4.34, 25.80]; P = 0.006), and duration of motor block was similar. The complication rates were similar, but it was higher in the peripheral nerve block on subgroup analysis. The use of ketamine as an adjuvant to local anesthetics in regional nerve blocks for surgeries leads to longer duration of analgesia, sensory block, and lower opioid requirement with similar complication rates.
PMID:
42509581
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.
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