Association Between Low-Dose Ketamine After Periacetabular and/or Femoral Osteotomy and Postoperative Opioid Requirements.
Orthopaedic journal of sports medicine August 1, 2024 Nicholas G Girardi, Sean Malin, Christopher Zielenski et al.
Adding low-dose ketamine to a standard multimodal pain regimen after periacetabular osteotomy or derotational femoral osteotomy significantly reduces opioid use without worsening pain. In a prospective cohort of 145 patients, those receiving postoperative ketamine (0.1–1 mg/kg/h until 24 hours before discharge) consumed a mean of 119 morphine milligram equivalents (MMEs) per day, compared with 181 MMEs in the control group. Pain scores on the Defense and Veterans Pain Rating Scale were similar between groups (4.34 vs. 4.18), and discharge timing did not differ. The findings suggest ketamine can lower postoperative opioid requirements while maintaining adequate pain control.