Continuous ketamine infusion for surgical patients in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials with GRADE assessment.
Critical care (London, England) January 23, 2026 Abdulrahman Ibrahim Alzmmam, Reema Fahad Alghanem, Asma Alshahrani et al.
Continuous low-dose ketamine infusion in postoperative surgical ICU patients modestly reduces opioid consumption during the first 24 hours (by about 5.77 mg morphine equivalents) and lowers the incidence of postoperative nausea and vomiting (by 41%), but does not significantly improve pain scores, shorten mechanical ventilation time, or reduce ICU length of stay. Psychotomimetic side effects were infrequent and not significantly increased. Evidence quality was moderate for opioid reduction in adults and low to very low for other outcomes, indicating that larger trials are needed to clarify ketamine's role beyond these benefits.