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Colombian Journal of Anestesiology
versão impressa ISSN 0120-3347versão On-line ISSN 2256-2087
Resumo
CADAVID PUENTES, Adriana Margarita et al. Hemodynamic response to sub-anesthetic doses of ketamine for postoperative pain: systematic review. Rev. colomb. anestesiol. [online]. 2024, vol.52, n.2, 4. Epub 07-Mar-2024. ISSN 0120-3347. https://doi.org/10.5554/22562087.e1099.
Introduction:
Low-dose ketamine infusions have shown analgesic effectiveness for the management of postoperative pain. The impact of low-dose ketamine infusions on cardiovascular response is dose-dependent and requires a better knowledge about its effects on this population.
Objective:
To conduct a systematic review to describe changes in systolic, diastolic and mean arterial pressure, and heart rate 24, 48 and 72 hours after surgery.
Methods:
Randomized, controlled trials were reviewed in the Cochrane Library, PubMed, EMBASE, SciELO, Lilacs and grey literature on low-dose ketamine infusions for the study variables. The quality of the studies was assessed using the Cochrane's risk of bias tool.
Results:
Six randomized, controlled trials with 641 patients were included. Low-quality evidence was found suggestive of a lack of certainty of any significant differences in the systolic blood pressure variables at 24 hours (mean standard deviation -1.00, 95 % CI: -7.27 to 5.27). A statistically significant higher mean heart rate at 24 hours was identified in the low-dose ketamine infusion group, (mean standard deviation 1.64 95 % CI: 0.38 to 2.90) which did not reach clinical significance. A lower pain level and less use of opioids was identified in the low-dose ketamine infusion group.
Conclusions:
Low quality evidence was found, suggesting that low-dose ketamine infusions are not associated with significant changes in blood pressure or heart rate 24 - 48 hours after surgery. It is important to individualize cardiovascular risk for each case, before initiating treatment.
Palavras-chave : Ketamine; Postoperative pain; Hemodynamics; Blood pressure; Heart rate; Opioids; Psychomimetic; Anesthesiology.