Ketamine doesn’t affect postop delirium, pain

Editor's Note

Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds.

A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227), and a 1.0 mg/kg ketamine group (223).

There was no difference in delirium incidence between those in the combined ketamine groups and the placebo group (19.45% vs 19.82%). More postoperative hallucinations and nightmares occurred with increasing ketamine doses, compared with placebo.

There also were no significant differences among any of the groups in maximum pain scores or median opioid consumption over time.

Clinicians should reconsider the common, widespread practice of giving low doses of ketamine during surgery because the findings indicate it is not effective, the authors say.

A single subanaesthetic dose of ketamine did not decrease delirium in older adults after major surgery, and might cause harm by inducing negative experiences.