{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T21:02:55Z","timestamp":1784408575268,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,18]]},"DOI":"10.7759\/cureus.112926","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T20:58:54Z","timestamp":1784408334000},"source":"Crossref","is-referenced-by-count":0,"title":["Opioid-Sparing Effects of Perioperative Ketamine With Inconsistent Analgesic Benefit in Orthopedic Surgery: A Systematic Review of Controlled Trials"],"prefix":"10.7759","author":[{"given":"Mackenzie","family":"Buckholz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armon","family":"Moradian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan M","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Forrest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Pisarski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin J","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/bor.0b013e32831bc0d7","article-title":"Obesity and the musculoskeletal system","volume":"21","author":"Anandacoomarasamy A","year":"2009","unstructured":"Anandacoomarasamy A, Fransen M, March L. Obesity and the musculoskeletal system. Curr Opin Rheumatol. 2009, 21:71-7. 10.1097\/bor.0b013e32831bc0d7","journal-title":"Curr Opin Rheumatol"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu464","article-title":"Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis","volume":"54","author":"Thijssen E","year":"2015","unstructured":"Thijssen E, van Caam A, van der Kraan PM. Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology (Oxford). 2015, 54:588-600. 10.1093\/rheumatology\/keu464","journal-title":"Rheumatology (Oxford)"},{"key":"ref3","unstructured":"National ambulatory medical care survey. (2019). https.\/\/stacks.cdc.gov\/view\/cdc\/123251."},{"key":"ref4","unstructured":"Surgical management of osteoarthritis of the knee. (2022). Accessed. April 24, 2026: https:\/\/www.aaos.org\/quality\/quality-programs\/surgical-management-of-osteoarthritis-of-the-knee\/."},{"key":"ref5","unstructured":"Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project. Overview of operating room procedures during inpatient stays in U.S. hospitals. (2018). Accessed: August 29, 2024: http:\/\/us.ahrq.gov\/reports\/statbriefs\/sb281-Operating-Room-Procedures-During-Hospitalization-2018.jsp."},{"key":"ref6","article-title":"Opioid analgesics","author":"Cohen B","year":"2023","unstructured":"Cohen B, Ruth LJ, Preuss CV. Opioid analgesics. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL); 2023."},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.52965\/001c.158576","article-title":"Commonly used opioids in the orthopedic operating room: a narrative review","volume":"18","author":"Nguyen A","year":"2026","unstructured":"Nguyen A, Donnelly J, Robinson CL, Hasoon J. Commonly used opioids in the orthopedic operating room: a narrative review. Orthop Rev (Pavia). 2026, 18:158576. 10.52965\/001c.158576","journal-title":"Orthop Rev (Pavia)"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15262","article-title":"An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients","volume":"76","author":"Levy N","year":"2021","unstructured":"Levy N, Quinlan J, El-Boghdadly K, et al.. An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients. Anaesthesia. 2021, 76:520-36. 10.1111\/anae.15262","journal-title":"Anaesthesia"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.53365","article-title":"Ketamine in chronic pain: a review","volume":"16","author":"Fa\u00edsco A","year":"2024","unstructured":"Fa\u00edsco A, Dinis R, Seixas T, Lopes L. Ketamine in chronic pain: a review. Cureus. 2024, 16:e53365. 10.7759\/cureus.53365","journal-title":"Cureus"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.05.043","article-title":"Low-dose ketamine in painful orthopaedic surgery: a systematic review and meta-analysis","volume":"123","author":"Riddell JM","year":"2019","unstructured":"Riddell JM, Trummel JM, Onakpoya IJ. Low-dose ketamine in painful orthopaedic surgery: a systematic review and meta-analysis. Br J Anaesth. 2019, 123:325-34. 10.1016\/j.bja.2019.05.043","journal-title":"Br J Anaesth"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-015-0551-4","article-title":"Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials","volume":"63","author":"Wang L","year":"2016","unstructured":"Wang L, Johnston B, Kaushal A, Cheng D, Zhu F, Martin J. Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials. Can J Anaesth. 2016, 63:311-25. 10.1007\/s12630-015-0551-4","journal-title":"Can J Anaesth"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20150701-61","article-title":"Multimodal analgesia for total joint arthroplasty","volume":"38","author":"Halawi MJ","year":"2015","unstructured":"Halawi MJ, Grant SA, Bolognesi MP. Multimodal analgesia for total joint arthroplasty. Orthopedics. 2015, 38:e616-25. 10.3928\/01477447-20150701-61","journal-title":"Orthopedics"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.02.037","article-title":"Prospective randomized study using pharmacogenetics to customize postoperative pain medication following hip and knee arthroplasty","volume":"37","author":"Hamilton WG","year":"2022","unstructured":"Hamilton WG, Gargiulo JM, Reynolds TR, Parks NL. Prospective randomized study using pharmacogenetics to customize postoperative pain medication following hip and knee arthroplasty. J Arthroplasty. 2022, 37:S76-81. 10.1016\/j.arth.2022.02.037","journal-title":"J Arthroplasty"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/TGR.0000000000000215","article-title":"The role multimodal pain management plays with successful total knee and hip arthroplasty","volume":"35","author":"Warren KG Jr","year":"2019","unstructured":"Warren KG Jr, Froehlich M, Feldman D. The role multimodal pain management plays with successful total knee and hip arthroplasty. Top Geriatr Rehabil. 2019, 35:42-54. 10.1097\/TGR.0000000000000215","journal-title":"Top Geriatr Rehabil"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.366","article-title":"The changing face of heroin use in the United States: a retrospective analysis of the past 50 years","volume":"71","author":"Cicero TJ","year":"2014","unstructured":"Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014, 71:821-6. 10.1001\/jamapsychiatry.2014.366","journal-title":"JAMA Psychiatry"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s10571-020-01013-y","article-title":"Oxycodone in the opioid epidemic: high 'liking', 'wanting', and abuse liability","volume":"41","author":"Kibaly C","year":"2021","unstructured":"Kibaly C, Alderete JA, Liu SH, Nasef HS, Law PY, Evans CJ, Cahill CM. Oxycodone in the opioid epidemic: high 'liking', 'wanting', and abuse liability. Cell Mol Neurobiol. 2021, 41:899-926. 10.1007\/s10571-020-01013-y","journal-title":"Cell Mol Neurobiol"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al.. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021, 372:n71. 10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)90884-8","article-title":"Measurement of pain","volume":"2","author":"Huskisson EC","year":"1974","unstructured":"Huskisson EC. Measurement of pain. Lancet. 1974, 2:1127-31. 10.1016\/S0140-6736(74)90884-8","journal-title":"Lancet"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(86)90228-9","article-title":"The measurement of clinical pain intensity: a comparison of six methods","volume":"27","author":"Jensen MP","year":"1986","unstructured":"Jensen MP, Karoly P, Braver S. . The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986, 27:117-26. 10.1016\/0304-3959(86)90228-9","journal-title":"Pain"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-22-00430","article-title":"The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials","volume":"21","author":"Barker TH","year":"2023","unstructured":"Barker TH, Stone JC, Sears K, et al.. The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evid Synth. 2023, 21:494-506. 10.11124\/JBIES-22-00430","journal-title":"JBI Evid Synth"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004729","article-title":"Analgesic effect of intraoperative intravenous S-ketamine in opioid-na\u00efve patients after major lumbar fusion surgery is temporary and not dose-dependent: a randomized, double-blind, placebo-controlled clinical trial","volume":"132","author":"Brinck EC","year":"2021","unstructured":"Brinck EC, Maisniemi K, Kankare J, Tielinen L, Tarkkila P, Kontinen VK. Analgesic effect of intraoperative intravenous S-ketamine in opioid-na\u00efve patients after major lumbar fusion surgery is temporary and not dose-dependent: a randomized, double-blind, placebo-controlled clinical trial. Anesth Analg. 2021, 132:69-79. 10.1213\/ANE.0000000000004729","journal-title":"Anesth Analg"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252626","article-title":"S-ketamine in patient-controlled analgesia reduces opioid consumption in a dose-dependent manner after major lumbar fusion surgery: a randomized, double-blind, placebo-controlled clinical trial","volume":"16","author":"Brinck EC","year":"2021","unstructured":"Brinck EC, Virtanen T, M\u00e4kel\u00e4 S, et al.. S-ketamine in patient-controlled analgesia reduces opioid consumption in a dose-dependent manner after major lumbar fusion surgery: a randomized, double-blind, placebo-controlled clinical trial. PLoS One. 2021, 16:e0252626. 10.1371\/journal.pone.0252626","journal-title":"PLoS One"},{"key":"ref23","article-title":"Intraoperative low-dose ketamine infusion reduces acute postoperative pain following total knee replacement surgery: a prospective, randomized double-blind placebo-controlled trial","volume":"24","author":"Cengiz P","year":"2014","unstructured":"Cengiz P, Gokcinar D, Karabeyoglu I, Topcu H, Cicek GS, Gogus N. Intraoperative low-dose ketamine infusion reduces acute postoperative pain following total knee replacement surgery: a prospective, randomized double-blind placebo-controlled trial. J Coll Physicians Surg Pak. 2014, 24:299-303.","journal-title":"J Coll Physicians Surg Pak"},{"key":"ref24","article-title":"A prospective randomized comparative study of gelfoam soaked nalbuphine vs ketamine placed in epidural space during lumbar spine surgery for postoperative analgesia","volume":"22","author":"Giri MK","year":"2018","unstructured":"Giri MK, Singh V, Pal P, et al.. A prospective randomized comparative study of gelfoam soaked nalbuphine vs ketamine placed in epidural space during lumbar spine surgery for postoperative analgesia. Anaesth Pain Intensive Care. 2018, 22:492-8.","journal-title":"Anaesth Pain Intensive Care"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.inat.2023.101767","article-title":"Comparison of dexmedetomidine and ketamine in adjuvant with morphine for postoperative pain management following lumbar fusion surgery","volume":"33","author":"Jelodar AG","year":"2023","unstructured":"Jelodar AG, Makrani NF, Shafizad M, et al.. Comparison of dexmedetomidine and ketamine in adjuvant with morphine for postoperative pain management following lumbar fusion surgery. Interdiscip Neurosurg. 2023, 33:101767. 10.1016\/j.inat.2023.101767","journal-title":"Interdiscip Neurosurg"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-015-2346-z","article-title":"Effect of preemptive intra-articular morphine and ketamine on pain after arthroscopic rotator cuff repair: a prospective, double-blind, randomized controlled study","volume":"136","author":"Khashan M","year":"2016","unstructured":"Khashan M, Dolkart O, Amar E, et al.. Effect of preemptive intra-articular morphine and ketamine on pain after arthroscopic rotator cuff repair: a prospective, double-blind, randomized controlled study. Arch Orthop Trauma Surg. 2016, 136:233-9. 10.1007\/s00402-015-2346-z","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12495","article-title":"The analgesic efficiency of combined pregabalin and ketamine for total hip arthroplasty: a randomised, double-blind, controlled study","volume":"69","author":"Martinez V","year":"2014","unstructured":"Martinez V, Cymerman A, Ben Ammar S, et al.. The analgesic efficiency of combined pregabalin and ketamine for total hip arthroplasty: a randomised, double-blind, controlled study. Anaesthesia. 2014, 69:46-52. 10.1111\/anae.12495","journal-title":"Anaesthesia"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000782","article-title":"Intraoperative ketamine reduces immediate postoperative opioid consumption after spinal fusion surgery in chronic pain patients with opioid dependency: a randomized, blinded trial","volume":"158","author":"Nielsen RV","year":"2017","unstructured":"Nielsen RV, Fomsgaard JS, Siegel H, Martusevicius R, Nikolajsen L, Dahl JB, Mathiesen O. Intraoperative ketamine reduces immediate postoperative opioid consumption after spinal fusion surgery in chronic pain patients with opioid dependency: a randomized, blinded trial. Pain. 2017, 158:463-70. 10.1097\/j.pain.0000000000000782","journal-title":"Pain"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjane.2021.07.014","article-title":"Inkk Trial .\u00c7\u00f4 Intraoperative ketamine for perioperative pain management following total knee endoprosthetic replacement in oncology: a double-blinded randomized trial","volume":"73","author":"Paulin VS","year":"2023","unstructured":"Paulin VS, Bakshi SG, Hegde PC, Rathod A, Gulia A, Kulkarni AM, Paramanandam VS. Inkk Trial .\u00c7\u00f4 Intraoperative ketamine for perioperative pain management following total knee endoprosthetic replacement in oncology: a double-blinded randomized trial. Braz J Anesthesiol. 2023, 73:78-84. 10.1016\/j.bjane.2021.07.014","journal-title":"Braz J Anesthesiol"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000000914","article-title":"Adding ketamine to epidural morphine does not prolong postoperative analgesia after lumbar laminectomy or discectomy","volume":"36","author":"Prabhakar P","year":"2024","unstructured":"Prabhakar P, Mariappan R, Moorthy RK, Nair BR, Karuppusami R, Lionel KR. Adding ketamine to epidural morphine does not prolong postoperative analgesia after lumbar laminectomy or discectomy. J Neurosurg Anesthesiol. 2024, 36:244-51. 10.1097\/ANA.0000000000000914","journal-title":"J Neurosurg Anesthesiol"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.47009\/jamp.2024.6.2.193","article-title":"Analgesic effect of intravenous ketamine on postoperative pain scores after surgery: a randomized double-blind study","volume":"6","author":"Sharma P","year":"2024","unstructured":"Sharma P, Gandhi KK, Khan FR, et al.. Analgesic effect of intravenous ketamine on postoperative pain scores after surgery: a randomized double-blind study. Int J Acad Med Pharm. 2024, 6:944-50. 10.47009\/jamp.2024.6.2.193","journal-title":"Int J Acad Med Pharm"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/495100-opioid-sparing-effects-of-perioperative-ketamine-with-inconsistent-analgesic-benefit-in-orthopedic-surgery-a-systematic-review-of-controlled-trials","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T20:58:56Z","timestamp":1784408336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/495100-opioid-sparing-effects-of-perioperative-ketamine-with-inconsistent-analgesic-benefit-in-orthopedic-surgery-a-systematic-review-of-controlled-trials"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,18]]},"references-count":31,"URL":"https:\/\/doi.org\/10.7759\/cureus.112926","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,18]]}}}