{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:48:59Z","timestamp":1787161739252,"version":"build-2736575974"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Perioperative use of ketamine has been discussed widely in many kinds of surgery. The aim of our study was to evaluate the short\u2010term and long\u2010term benefits and safety of ketamine after breast surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We performed a quantitative systematic review. We included randomized controlled trials that compared intravenous administration of ketamine to a placebo control group, or compared bupivacaine in combination with ketamine to bupivacaine alone in thoracic paravertebral blocks or pectoral blocks among patients undergoing breast surgery. The primary outcome was postoperative pain intensity. Secondary outcomes included cumulative opioid consumption during the 0\u2010 to 24\u2010hour postoperative period, the effect on postmastectomy pain syndrome, the effect on postoperative depression, and the adverse events associated with the use of ketamine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen randomized controlled trials with 1,182 patients were included for analysis. Compared with placebo, intravenous ketamine was effective in reducing wound pain intensity during the first 6\u00a0hours after surgery (weighted mean difference [WMD]\u00a0\u22120.83; 95% confidence interval [CI]\u00a0\u22121.65, \u22120.01;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a00.048) and during the first 24\u00a0hours after surgery (WMD\u00a0\u22120.65; 95% CI \u22120.95, \u22120.35;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and in decreasing opioid consumption (WMD\u00a0\u22124.14; 95% CI\u00a0\u22128.00, \u22120.29;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.035) during the first 24\u00a0hours after surgery, without increasing the risks for gastrointestinal and central nervous system adverse events. Adding ketamine to bupivacaine in thoracic paravertebral blocks was also effective in reducing postoperative wound pain during the first 6\u00a0hours after surgery (WMD\u00a0\u22120.59; 95% CI, \u22121.06, \u22120.12;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.014) and during the first 24\u00a0hours after surgery (WMD\u00a0\u22120.90; 95% CI \u22121.27, \u22120.53;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and in decreasing opioid consumption (WMD\u00a0\u2212\u00a04.59; 95% CI\u00a0\u22125.76, \u22123.42;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) during the first 24\u00a0hours after surgery. Perioperative use of ketamine was associated with improved postoperative depression symptoms (standardized mean difference\u00a0\u22120.80; 95% CI\u00a0\u2212\u00a01.34, \u22120.27;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.003) and less incidence of postmastectomy pain syndrome (relative risk 0.79; 95% CI 0.63, 0.99;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.043).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ketamine is an effective and safe multimodal analgesic in patients undergoing breast surgery, administered both intravenously and when added to bupivacaine in paravertebral blocks. In addition, ketamine showed a long\u2010term benefit for preventing postoperative depression and postmastectomy pain syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.12961","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T02:54:30Z","timestamp":1604544870000},"page":"316-332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["The Effect of Ketamine on Acute and Chronic Wound Pain in Patients Undergoing Breast Surgery: A Meta\u2010Analysis and Systematic Review"],"prefix":"10.1111","volume":"21","author":[{"given":"Yaodan","family":"Bi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology West China Hospital Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology West China Hospital Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinchao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology West China Hospital Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology West China Hospital Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuqian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology West China Hospital Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-0053","authenticated-orcid":false,"given":"Bin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology West China Hospital Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2015-0008"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-013-2225-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2017.11.001"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2012.01.019"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12739"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601150"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026564723698"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3027"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38343.670868.D3"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-016-0120-y"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-016-0591-7"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30430-1"},{"key":"e_1_2_12_14_1","first-page":"61","article-title":"Ketamine: a review of its pharmacologic properties and use in ambulatory anesthesia","volume":"39","author":"Haas DA","year":"1992","journal-title":"Anesth Prog."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-028337"},{"key":"e_1_2_12_16_1","first-page":"Cd012033","article-title":"Perioperative intravenous ketamine for acute postoperative pain in adults","volume":"12","author":"Brinck EC","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_12_17_1","first-page":"456","article-title":"Consensus guidelines on the use of intravenous ketamine infusions for acute pain management from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists","volume":"43","author":"Schwenk ES","year":"2018","journal-title":"Reg Anesth Pain Med."},{"key":"e_1_2_12_18_1","first-page":"1","article-title":"Effect of Pretreatment of S\u2010Ketamine On Postoperative Depression for Breast Cancer Patients","author":"Liu Peirong","year":"2020","journal-title":"Journal of Investigative Surgery"},{"key":"e_1_2_12_19_1","first-page":"25","article-title":"The effect of ketamine infusion on post mastectomy pain syndrome: a randomized controlled study","volume":"2014","author":"Bakr M","year":"2014","journal-title":"SECI Oncol."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2017.05.006"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-011-9560-0"},{"key":"e_1_2_12_22_1","unstructured":"HigginsJGS.Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0 [updated March 2011]. 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