{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:46:51Z","timestamp":1790077611463,"version":"4.0.1"},"reference-count":62,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"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":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objective<\/jats:title>\n                    <jats:p>Assessment of the efficacy and safety of perioperative intravenous ketamine in reducing incidence and severity of chronic postsurgical pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis of randomized controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      Data Source\n                      <jats:bold>s<\/jats:bold>\n                    <\/jats:title>\n                    <jats:p>The following data sources were systematically searched: MEDLINE, CENTRAL, and EMBASE (till 02\/2021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Adult patients undergoing any surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Perioperative use of intravenous ketamine as an additive analgesic drug compared to placebo, no active control treatment, and other additive drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary outcomes were number of patients with chronic postsurgical pain after 6\u2009months and ketamine related adverse effects. Secondary outcomes were chronic postsurgical pain incidence after 3 and 12\u2009months, chronic postsurgical neuropathic pain incidence, chronic postsurgical moderate to severe pain incidence, intensity of chronic postsurgical pain at rest, and during movement, oral morphine consumption after 3, 6, and 12\u2009months and incidence of opioid\u2010related adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010six RCTs were included with a total of 3572 patients. Ketamine compared to placebo may result in no difference in the number of patients with chronic postsurgical pain after 6\u2009months (risk ratio (RR) 0.86, 95% confidence interval (CI) 0.71\u20131.05;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200934%; 16 studies; low\u2010certainty evidence). Ketamine may reduce the incidence of chronic postsurgical neuropathic pain after 3\u2009months in comparison to placebo (RR 0.78, 95% CI 0.62\u20130.99,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200931%, seven trials, low\u2010certainty evidence). Ketamine compared to placebo may increase the risk for postoperative nystagmus (RR 9.04, 95% CI 1.15\u201370.90,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      30%, two trials, low\u2010certainty evidence) and postoperative visual disturbances (RR 2.29, 95% CI 1.05\u20134.99,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      10%, seven trials, low\u2010certainty evidence).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is low\u2010certainty evidence that perioperative ketamine has no effect on chronic postsurgical pain in adult patients. Low\u2010certainty evidence suggests that ketamine compared to placebo may reduce incidence of chronic postsurgical neuropathic pain after 3\u2009months. Questions like ideal dosing, treatment duration and more patient\u2010related outcome measures remain unanswered, which warrants further studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Protocol Registration<\/jats:title>\n                    <jats:p>Prospero CRD42021223625, 07.01.2021.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.13314","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T06:06:15Z","timestamp":1700114775000},"page":"553-566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Efficacy and safety of perioperative ketamine for the prevention of chronic postsurgical pain: A meta\u2010analysis"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0089-8724","authenticated-orcid":false,"given":"Ahmed H.","family":"Abouarab","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Medicine University Hospital of Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Br\u00fclle","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Medicine University Hospital of Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Y.","family":"Aboukilila","sequence":"additional","affiliation":[{"name":"Institute of Biochemistry University of Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Weibel","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine University Hospital of W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schnabel","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Medicine University Hospital of Muenster  Muenster 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