Skip to main content
Erschienen in: Obesity Surgery 12/2021

13.10.2021 | Review

Impact of Intraoperative Ketamine on Postoperative Analgesic Requirement Following Bariatric Surgery: a Meta-analysis of Randomized Controlled Trials

verfasst von: Kuo-Chuan Hung, Shao-Chun Wu, Po-Chih Chang, I.-Wen Chen, Chung-Hsi Hsing, Chien-Ming Lin, Jen-Yin Chen, Chin-Chen Chu, Cheuk-Kwan Sun

Erschienen in: Obesity Surgery | Ausgabe 12/2021

Einloggen, um Zugang zu erhalten

Abstract

This meta-analysis aimed at exploring the impact of intravenous ketamine on pain relief and analgesic consumption in patients undergoing bariatric surgery (BS). Literature searches identified nine eligible trials with 458 participants. Forest plot revealed a significantly lower pain score [mean difference (MD) =  − 1.06, p = 0.005; 390 patients) and morphine consumption (MD =  − 3.85 mg, p = 0.01; 212 patients) immediately after BS in patients with intravenous ketamine than in those without. In contrast, pooled analysis showed comparable pain score (p = 0.28), morphine consumption (p = 0.45) within 24 h, and risk of postoperative nausea/vomiting (p = 0.67) between the two groups. In conclusion, the meta-analysis demonstrated improvements in pain outcomes immediately after surgery through perioperative intravenous ketamine administration despite the absence of analgesic benefit in the late postoperative period and a positive impact on postoperative nausea/vomiting.

Graphical abstract

Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020;324:879–87.PubMedCrossRef Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020;324:879–87.PubMedCrossRef
2.
Zurück zum Zitat Wiggins T, Guidozzi N, Welbourn R, et al. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: A systematic review and meta-analysis. PLOS Medicine. 2020;17:e1003206 Wiggins T, Guidozzi N, Welbourn R, et al. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: A systematic review and meta-analysis. PLOS Medicine. 2020;17:e1003206
3.
Zurück zum Zitat Joris JL, Hinque VL, Laurent PE, et al. Pulmonary function and pain after gastroplasty performed via laparotomy or laparoscopy in morbidly obese patients. Br J Anaesth. 1998;80:283–8.PubMedCrossRef Joris JL, Hinque VL, Laurent PE, et al. Pulmonary function and pain after gastroplasty performed via laparotomy or laparoscopy in morbidly obese patients. Br J Anaesth. 1998;80:283–8.PubMedCrossRef
4.
Zurück zum Zitat Campbell AL, Yu S, Karia R, et al. The effects of body mass index on pain control with liposomal bupivacaine in hip and knee arthroplasty. J Arthroplasty. 2018;33:1033–9.PubMedCrossRef Campbell AL, Yu S, Karia R, et al. The effects of body mass index on pain control with liposomal bupivacaine in hip and knee arthroplasty. J Arthroplasty. 2018;33:1033–9.PubMedCrossRef
5.
Zurück zum Zitat Majchrzak M, Brzecka A, Daroszewski C, et al. Increased pain sensitivity in obese patients after lung cancer surgery. Front Pharmacol. 2019;10:626.PubMedPubMedCentralCrossRef Majchrzak M, Brzecka A, Daroszewski C, et al. Increased pain sensitivity in obese patients after lung cancer surgery. Front Pharmacol. 2019;10:626.PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat Lopez PP, Stefan B, Schulman CI, et al. Prevalence of sleep apnea in morbidly obese patients who presented for weight loss surgery evaluation: more evidence for routine screening for obstructive sleep apnea before weight loss surgery. Am Surg. 2008;74:834–8.PubMedCrossRef Lopez PP, Stefan B, Schulman CI, et al. Prevalence of sleep apnea in morbidly obese patients who presented for weight loss surgery evaluation: more evidence for routine screening for obstructive sleep apnea before weight loss surgery. Am Surg. 2008;74:834–8.PubMedCrossRef
7.
Zurück zum Zitat Kaw R, Chung F, Pasupuleti V, et al. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome. Br J Anaesth. 2012;109:897–906.PubMedCrossRef Kaw R, Chung F, Pasupuleti V, et al. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome. Br J Anaesth. 2012;109:897–906.PubMedCrossRef
8.
Zurück zum Zitat Blake DW, Chia PH, Donnan G, et al. Preoperative assessment for obstructive sleep apnoea and the prediction of postoperative respiratory obstruction and hypoxaemia. Anaesth Intensive Care. 2008;36:379–84.PubMedCrossRef Blake DW, Chia PH, Donnan G, et al. Preoperative assessment for obstructive sleep apnoea and the prediction of postoperative respiratory obstruction and hypoxaemia. Anaesth Intensive Care. 2008;36:379–84.PubMedCrossRef
9.
Zurück zum Zitat Practice guidelines for the perioperative management of patients with obstructive sleep apnea: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology. 2014;120:268–86 Practice guidelines for the perioperative management of patients with obstructive sleep apnea: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology. 2014;120:268–86
10.
Zurück zum Zitat Gross JB, Bachenberg KL, Benumof JL, et al. Practice guidelines for the perioperative management of patients with obstructive sleep apnea: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology. 2006;104:1081–93; quiz 117–8 Gross JB, Bachenberg KL, Benumof JL, et al. Practice guidelines for the perioperative management of patients with obstructive sleep apnea: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology. 2006;104:1081–93; quiz 117–8
11.
Zurück zum Zitat Schuligoi R, Jocic M, Heinemann A, et al. Gastric acid-evoked c-fos messenger RNA expression in rat brainstem is signaled by capsaicin-resistant vagal afferents. Gastroenterology. 1998;115:649–60.PubMedCrossRef Schuligoi R, Jocic M, Heinemann A, et al. Gastric acid-evoked c-fos messenger RNA expression in rat brainstem is signaled by capsaicin-resistant vagal afferents. Gastroenterology. 1998;115:649–60.PubMedCrossRef
12.
Zurück zum Zitat Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993;77:1048–56.PubMed Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993;77:1048–56.PubMed
13.
Zurück zum Zitat Thorell A, MacCormick AD, Awad S, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg. 2016;40:2065–83.PubMedCrossRef Thorell A, MacCormick AD, Awad S, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg. 2016;40:2065–83.PubMedCrossRef
14.
Zurück zum Zitat Abou Zeid H, Kallab R, Najm MA, et al. Safety and efficacy of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) used for analgesia after bariatric surgery: a retrospective case-control study. Obes Surg. 2019;29:911–6.PubMedCrossRef Abou Zeid H, Kallab R, Najm MA, et al. Safety and efficacy of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) used for analgesia after bariatric surgery: a retrospective case-control study. Obes Surg. 2019;29:911–6.PubMedCrossRef
15.
Zurück zum Zitat De Oliveira GS, Jr., Duncan K, Fitzgerald P, et al. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014;24:212-8 De Oliveira GS, Jr., Duncan K, Fitzgerald P, et al. Systemic lidocaine to improve quality of recovery after laparoscopic bariatric surgery: a randomized double-blinded placebo-controlled trial. Obes Surg. 2014;24:212-8
16.
Zurück zum Zitat Singh PM, Panwar R, Borle A, et al. Perioperative analgesic profile of dexmedetomidine infusions in morbidly obese undergoing bariatric surgery: a meta-analysis and trial sequential analysis. Surg Obes Relat Dis. 2017;13:1434–46.PubMedCrossRef Singh PM, Panwar R, Borle A, et al. Perioperative analgesic profile of dexmedetomidine infusions in morbidly obese undergoing bariatric surgery: a meta-analysis and trial sequential analysis. Surg Obes Relat Dis. 2017;13:1434–46.PubMedCrossRef
17.
Zurück zum Zitat Cabrera Schulmeyer MC, de la Maza J, Ovalle C, et al. Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy. Obes Surg. 2010;20:1678–81.PubMedCrossRef Cabrera Schulmeyer MC, de la Maza J, Ovalle C, et al. Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy. Obes Surg. 2010;20:1678–81.PubMedCrossRef
18.
Zurück zum Zitat Suzuki M. Role of N-methyl-D-aspartate receptor antagonists in postoperative pain management. Curr Opin Anaesthesiol. 2009;22:618–22.PubMedCrossRef Suzuki M. Role of N-methyl-D-aspartate receptor antagonists in postoperative pain management. Curr Opin Anaesthesiol. 2009;22:618–22.PubMedCrossRef
19.
Zurück zum Zitat Peltoniemi MA, Hagelberg NM, Olkkola KT, et al. Ketamine: a review of clinical pharmacokinetics and pharmacodynamics in anesthesia and pain therapy. Clin Pharmacokinet. 2016;55:1059–77.PubMedCrossRef Peltoniemi MA, Hagelberg NM, Olkkola KT, et al. Ketamine: a review of clinical pharmacokinetics and pharmacodynamics in anesthesia and pain therapy. Clin Pharmacokinet. 2016;55:1059–77.PubMedCrossRef
20.
Zurück zum Zitat Radvansky BM, Puri S, Sifonios AN, et al. Ketamine-A narrative review of its uses in medicine. Am J Ther. 2016;23:e1414–26.PubMedCrossRef Radvansky BM, Puri S, Sifonios AN, et al. Ketamine-A narrative review of its uses in medicine. Am J Ther. 2016;23:e1414–26.PubMedCrossRef
21.
Zurück zum Zitat Erstad BL, Patanwala AE. Ketamine for analgosedation in critically ill patients. J Crit Care. 2016;35:145–9.PubMedCrossRef Erstad BL, Patanwala AE. Ketamine for analgosedation in critically ill patients. J Crit Care. 2016;35:145–9.PubMedCrossRef
22.
Zurück zum Zitat Zakine J, Samarcq D, Lorne E, et al. Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study. Anesth Analg. 2008;106:1856–61.PubMedCrossRef Zakine J, Samarcq D, Lorne E, et al. Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study. Anesth Analg. 2008;106:1856–61.PubMedCrossRef
23.
Zurück zum Zitat Radvansky BM, Shah K, Parikh A, et al. Role of ketamine in acute postoperative pain management: a narrative review. Biomed Res Int. 2015;2015:749837 Radvansky BM, Shah K, Parikh A, et al. Role of ketamine in acute postoperative pain management: a narrative review. Biomed Res Int. 2015;2015:749837
24.
Zurück zum Zitat Schwenk ES, Viscusi ER, Buvanendran A, et al. 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. Reg Anesth Pain Med. 2018;43:456–66.PubMedPubMedCentral Schwenk ES, Viscusi ER, Buvanendran A, et al. 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. Reg Anesth Pain Med. 2018;43:456–66.PubMedPubMedCentral
25.
Zurück zum Zitat Laskowski K, Stirling A, McKay WP, et al. A systematic review of intravenous ketamine for postoperative analgesia. Can J Anaesth. 2011;58:911–23.PubMedCrossRef Laskowski K, Stirling A, McKay WP, et al. A systematic review of intravenous ketamine for postoperative analgesia. Can J Anaesth. 2011;58:911–23.PubMedCrossRef
26.
Zurück zum Zitat Wang L, Johnston B, Kaushal A, et al. 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.PubMedCrossRef Wang L, Johnston B, Kaushal A, et al. 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.PubMedCrossRef
27.
Zurück zum Zitat Wang X, Lin C, Lan L, et al. Perioperative intravenous S-ketamine for acute postoperative pain in adults: A systematic review and meta-analysis. J Clin Anesth. 2021;68:110071 Wang X, Lin C, Lan L, et al. Perioperative intravenous S-ketamine for acute postoperative pain in adults: A systematic review and meta-analysis. J Clin Anesth. 2021;68:110071
28.
Zurück zum Zitat Feld JM, Laurito CE, Beckerman M, et al. Non-opioid analgesia improves pain relief and decreases sedation after gastric bypass surgery. Can J Anaesth. 2003;50:336–41.PubMedCrossRef Feld JM, Laurito CE, Beckerman M, et al. Non-opioid analgesia improves pain relief and decreases sedation after gastric bypass surgery. Can J Anaesth. 2003;50:336–41.PubMedCrossRef
29.
Zurück zum Zitat Hasanein R, El-Sayed W, Nabil N, et al. The effect of combined remifentanil and low dose ketamine infusion in patients undergoing laparoscopic gastric bypass. Egypt J Anaesth. 2011;27:255–60.CrossRef Hasanein R, El-Sayed W, Nabil N, et al. The effect of combined remifentanil and low dose ketamine infusion in patients undergoing laparoscopic gastric bypass. Egypt J Anaesth. 2011;27:255–60.CrossRef
30.
Zurück zum Zitat Adhikary SD, Thiruvenkatarajan V, McFadden A, et al. Analgesic efficacy of ketamine and magnesium after laparoscopic sleeve gastrectomy: A randomized, double-blind, placebo-controlled trial. J Clin Anesthesia. 2021;68:110097 Adhikary SD, Thiruvenkatarajan V, McFadden A, et al. Analgesic efficacy of ketamine and magnesium after laparoscopic sleeve gastrectomy: A randomized, double-blind, placebo-controlled trial. J Clin Anesthesia. 2021;68:110097
31.
Zurück zum Zitat Taylor S, Kirton OC, Staff I, et al. Postoperative day one: a high risk period for respiratory events. Am J Surg. 2005;190:752–6.PubMedCrossRef Taylor S, Kirton OC, Staff I, et al. Postoperative day one: a high risk period for respiratory events. Am J Surg. 2005;190:752–6.PubMedCrossRef
32.
Zurück zum Zitat DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.PubMedCrossRef DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.PubMedCrossRef
33.
Zurück zum Zitat Seib RK, Paul JE. Preoperative gabapentin for postoperative analgesia: a meta-analysis. Can J Anaesth. 2006;53:461–9.PubMedCrossRef Seib RK, Paul JE. Preoperative gabapentin for postoperative analgesia: a meta-analysis. Can J Anaesth. 2006;53:461–9.PubMedCrossRef
34.
Zurück zum Zitat Jabbour H, Jabbour K, Abi Lutfallah A, et al. Magnesium and ketamine reduce early morphine consumption after open bariatric surgery: a prospective randomized double-blind study. Obes Surg. 2020;30:1452–8.PubMedCrossRef Jabbour H, Jabbour K, Abi Lutfallah A, et al. Magnesium and ketamine reduce early morphine consumption after open bariatric surgery: a prospective randomized double-blind study. Obes Surg. 2020;30:1452–8.PubMedCrossRef
35.
Zurück zum Zitat Kasputyte G, Karbonskiene A, Macas A, et al. Role of ketamine in multimodal analgesia protocol for bariatric surgery. Medicina. 2020;56:26.CrossRef Kasputyte G, Karbonskiene A, Macas A, et al. Role of ketamine in multimodal analgesia protocol for bariatric surgery. Medicina. 2020;56:26.CrossRef
36.
Zurück zum Zitat Mansour MA, Mahmoud AAA, Geddawy M. Nonopioid versus opioid based general anesthesia technique for bariatric surgery: A randomized double-blind study. Saudi J Anaesth. 2013;7:387–91.PubMedPubMedCentralCrossRef Mansour MA, Mahmoud AAA, Geddawy M. Nonopioid versus opioid based general anesthesia technique for bariatric surgery: A randomized double-blind study. Saudi J Anaesth. 2013;7:387–91.PubMedPubMedCentralCrossRef
37.
Zurück zum Zitat Mehta SD, Smyth D, Vasilopoulos T, et al. Ketamine infusion reduces narcotic requirements following gastric bypass surgery: a randomized controlled trial. Surg Obes Related Dis. 2021;17:737–43.CrossRef Mehta SD, Smyth D, Vasilopoulos T, et al. Ketamine infusion reduces narcotic requirements following gastric bypass surgery: a randomized controlled trial. Surg Obes Related Dis. 2021;17:737–43.CrossRef
38.
Zurück zum Zitat Sollazzi L, Modesti C, Vitale F, et al. Preinductive use of clonidine and ketamine improves recovery and reduces postoperative pain after bariatric surgery. Surg Obes Related Dis. 2009;5:67–71.CrossRef Sollazzi L, Modesti C, Vitale F, et al. Preinductive use of clonidine and ketamine improves recovery and reduces postoperative pain after bariatric surgery. Surg Obes Related Dis. 2009;5:67–71.CrossRef
39.
Zurück zum Zitat Wang J, Echevarria GC, Doan L, et al. Effects of a single subanaesthetic dose of ketamine on pain and mood after laparoscopic bariatric surgery: A randomised double-blind placebo controlled study. Eur J Anaesthesiol. 2019;36:16–24.PubMedCrossRef Wang J, Echevarria GC, Doan L, et al. Effects of a single subanaesthetic dose of ketamine on pain and mood after laparoscopic bariatric surgery: A randomised double-blind placebo controlled study. Eur J Anaesthesiol. 2019;36:16–24.PubMedCrossRef
40.
Zurück zum Zitat Sarton E, Teppema LJ, Olievier C, et al. The involvement of the mu-opioid receptor in ketamine-induced respiratory depression and antinociception. Anesth Analg. 2001;93:1495–500, table of contents Sarton E, Teppema LJ, Olievier C, et al. The involvement of the mu-opioid receptor in ketamine-induced respiratory depression and antinociception. Anesth Analg. 2001;93:1495–500, table of contents
41.
Zurück zum Zitat Berti M, Baciarello M, Troglio R, et al. Clinical uses of low-dose ketamine in patients undergoing surgery. Curr Drug Targets. 2009;10:707–15.PubMedCrossRef Berti M, Baciarello M, Troglio R, et al. Clinical uses of low-dose ketamine in patients undergoing surgery. Curr Drug Targets. 2009;10:707–15.PubMedCrossRef
42.
Zurück zum Zitat Koppert W, Schmelz M. The impact of opioid-induced hyperalgesia for postoperative pain. Best Pract Res Clin Anaesthesiol. 2007;21:65–83.PubMedCrossRef Koppert W, Schmelz M. The impact of opioid-induced hyperalgesia for postoperative pain. Best Pract Res Clin Anaesthesiol. 2007;21:65–83.PubMedCrossRef
43.
Zurück zum Zitat Willetts J, Rice A, Balster RL. (+)-N-Allylnormetazocine (NANM)-like discriminative stimulus effects of N-methyl-D-aspartate (NMDA) antagonists. Behav Pharmacol. 1990;1:453–8.PubMedCrossRef Willetts J, Rice A, Balster RL. (+)-N-Allylnormetazocine (NANM)-like discriminative stimulus effects of N-methyl-D-aspartate (NMDA) antagonists. Behav Pharmacol. 1990;1:453–8.PubMedCrossRef
44.
Zurück zum Zitat Bell RF, Dahl JB, Moore RA, et al. Peri-operative ketamine for acute post-operative pain: a quantitative and qualitative systematic review (Cochrane review). Acta Anaesthesiol Scand. 2005;49:1405–28.PubMedCrossRef Bell RF, Dahl JB, Moore RA, et al. Peri-operative ketamine for acute post-operative pain: a quantitative and qualitative systematic review (Cochrane review). Acta Anaesthesiol Scand. 2005;49:1405–28.PubMedCrossRef
45.
Zurück zum Zitat Elia N, Tramèr MR. Ketamine and postoperative pain–a quantitative systematic review of randomised trials. Pain. 2005;113:61–70.PubMedCrossRef Elia N, Tramèr MR. Ketamine and postoperative pain–a quantitative systematic review of randomised trials. Pain. 2005;113:61–70.PubMedCrossRef
46.
Zurück zum Zitat Loick HM, Schmidt C, Van Aken H, et al. High thoracic epidural anesthesia, but not clonidine, attenuates the perioperative stress response via sympatholysis and reduces the release of troponin T in patients undergoing coronary artery bypass grafting. Anesth Analg. 1999;88:701–9.PubMed Loick HM, Schmidt C, Van Aken H, et al. High thoracic epidural anesthesia, but not clonidine, attenuates the perioperative stress response via sympatholysis and reduces the release of troponin T in patients undergoing coronary artery bypass grafting. Anesth Analg. 1999;88:701–9.PubMed
47.
Zurück zum Zitat Ballantyne JC, Carr DB, deFerranti S, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg. 1998;86:598–612.PubMedCrossRef Ballantyne JC, Carr DB, deFerranti S, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg. 1998;86:598–612.PubMedCrossRef
48.
Zurück zum Zitat Ortega FB, Lavie CJ, Blair SN. Obesity and Cardiovascular Disease. Circ Res. 2016;118:1752–70.PubMedCrossRef Ortega FB, Lavie CJ, Blair SN. Obesity and Cardiovascular Disease. Circ Res. 2016;118:1752–70.PubMedCrossRef
49.
Zurück zum Zitat Dogan K, Kraaij L, Aarts EO, et al. Fast-track bariatric surgery improves perioperative care and logistics compared to conventional care. Obes Surg. 2015;25:28–35.PubMedCrossRef Dogan K, Kraaij L, Aarts EO, et al. Fast-track bariatric surgery improves perioperative care and logistics compared to conventional care. Obes Surg. 2015;25:28–35.PubMedCrossRef
51.
Zurück zum Zitat Soleimanpour H, Safari S, Sanaie S, et al. Anesthetic considerations in patients undergoing bariatric surgery: a review article. Anesth Pain Med. 2017;7:e57568 Soleimanpour H, Safari S, Sanaie S, et al. Anesthetic considerations in patients undergoing bariatric surgery: a review article. Anesth Pain Med. 2017;7:e57568
52.
Zurück zum Zitat Brinck EC, Tiippana E, Heesen M, et al. Perioperative intravenous ketamine for acute postoperative pain in adults. Cochrane Database Syst Rev. 2018;12:Cd012033 Brinck EC, Tiippana E, Heesen M, et al. Perioperative intravenous ketamine for acute postoperative pain in adults. Cochrane Database Syst Rev. 2018;12:Cd012033
53.
Zurück zum Zitat Zhou YL, Liu WJ, Wang CY, et al. Cardiovascular effects of repeated subanaesthetic ketamine infusion in depression. J Psychopharmacol. 2021;35:159–67.PubMedCrossRef Zhou YL, Liu WJ, Wang CY, et al. Cardiovascular effects of repeated subanaesthetic ketamine infusion in depression. J Psychopharmacol. 2021;35:159–67.PubMedCrossRef
54.
Zurück zum Zitat Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98–107.PubMedCrossRef Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98–107.PubMedCrossRef
55.
Zurück zum Zitat Himmelseher S, Durieux ME. Ketamine for perioperative pain management. Anesthesiology. 2005;102:211–20.PubMedCrossRef Himmelseher S, Durieux ME. Ketamine for perioperative pain management. Anesthesiology. 2005;102:211–20.PubMedCrossRef
Metadaten
Titel
Impact of Intraoperative Ketamine on Postoperative Analgesic Requirement Following Bariatric Surgery: a Meta-analysis of Randomized Controlled Trials
verfasst von
Kuo-Chuan Hung
Shao-Chun Wu
Po-Chih Chang
I.-Wen Chen
Chung-Hsi Hsing
Chien-Ming Lin
Jen-Yin Chen
Chin-Chen Chu
Cheuk-Kwan Sun
Publikationsdatum
13.10.2021
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2021
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05753-8

Weitere Artikel der Ausgabe 12/2021

Obesity Surgery 12/2021 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.