{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:29:19Z","timestamp":1793305759895,"version":"4.5.0"},"reference-count":67,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2022,3,31]]},"abstract":"<jats:p>\n                    Objective. Although low-dose ketamine has been shown to be generally beneficial in terms of pain control in a variety of major surgery, there is no consensus regarding the effectiveness of supplemental ketamine analgesic use exclusively in spine surgery. The objective of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to assess the efficacy and safety of perioperative low-dose ketamine for pain management and analgesic consumption in patients undergoing spine surgery. Methods. A comprehensive literature search was performed for relevant studies using PubMed, EMBASE, Web of Science, and Cochrane Library. Patients who received perioperative low-dose ketamine were compared to the control group in terms of postoperative pain intensity, opioid consumption, and adverse events. Patients were further categorized by ages and administration times for subgroup analysis. Results. A total of 30 RCTs comprising 1,865 patients undergoing elective spine surgery were included. Significantly lower pain intensity and less opioid consumption at 12\u2009h, 24\u2009h, and 48\u2009h postoperatively and lower incidence of postoperative nausea and vomiting (PONV) were observed in the ketamine group (all\n                    <jats:inline-formula>\n                      <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.05<\/a:mn>\n                      <\/a:math>\n                    <\/jats:inline-formula>\n                    ). There was no significant difference of central nervous system (CNS) adverse events between groups. However, different efficacy of low-dose ketamine was detected when patients were categorized by ages and administration times. Conclusion. Perioperative low-dose ketamine demonstrated analgesic and morphine-sparing effect with no increased adverse events after spine surgery. However, this effect was not significant in pediatric patients. Only postoperative or intraoperative and postoperative administration could prolong the analgesic time up to 48\u2009h postoperatively. Further studies should focus on the optimal protocol of ketamine administration and its effect on old age participants.\n                  <\/jats:p>","DOI":"10.1155\/2022\/1507097","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T14:20:11Z","timestamp":1648736411000},"page":"1-20","source":"Crossref","is-referenced-by-count":43,"title":["Perioperative Low-Dose Ketamine for Postoperative Pain Management in Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6960-5951","authenticated-orcid":true,"given":"Lijin","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5300-1283","authenticated-orcid":true,"given":"Honghao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-325X","authenticated-orcid":true,"given":"Yong","family":"Hai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5553-5211","authenticated-orcid":true,"given":"Yunzhong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000003320"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2018.00921"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.21037\/jss-19-306"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0000000000003364"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12660"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.3109\/15360288.2014.938889"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.2737"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-019-00660-0"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2019.01.001"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2019.05.04"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1097\/aln.0000000000003143"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.07.005"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.168149"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.182085"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-1-5"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.Ed000142"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.01973.x"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011747.pub2"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012033.pub4"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H421"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1016\/s0885-3924(01)00271-8"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341x.2000.00455.x"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1007\/bf03011736"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1163\/1568569042664413"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.10.005"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318183919e"},{"issue":"5","key":"28","first-page":"1151","article-title":"The combined effect of ketamine and remifentanil infusions as total intravenous anesthesia for scoliosis surgery in children","volume":"19","author":"A. 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