Ketamine Supplementation To Bupivacaine For Knee Arthroscopy: A Meta-Analysis of Randomized Controlled Trials

Abstract

Introduction: The efficacy of ketamine supplementation to bupivacaine for pain management of knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of ketamine supplementation to bupivacaine on the postoperative pain intensity of knee arthroscopy.Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through July 2021 for randomized controlled trials (RCTs) assessing the effect of ketamine supplementation to bupivacaine on pain control of knee arthroscopy. This meta-analysis is performed using the random-effect model.Results: Four RCTs are included in the meta-analysis. Overall, compared with control group for knee arthroscopy, ketamine supplementation remarkably decreases pain scores at 30 min (SMD=-0.98; 95% CI=-1.42 to -0.55; P<0.00001) and number of additional analgesics (OR=0.27; 95% CI=0.10 to 0.71; P=0.008), but reveals no significant impact on pain scores at 1 h (SMD=-1.34; 95% CI=-3.42 to 0.73; P=0.20), pain scores at 6 h (SMD=-0.33; 95% CI=-1.39 to 0.72; P=0.53), time of first analgesic requirement (SMD=1.27; 95% CI=-0.95 to 3.49; P=0.26) or additional analgesic consumption (SMD=-2.25; 95% CI=-5.89 to 1.40; P=0.23). Conclusions: Ketamine supplementation may improve the pain control when in combination with bupivacaine for knee arthroscopy.