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Prophylactic Analgesic Effect of Adding Ketamine to Bupivacaine in Lumbar Fusion Surgery: A Randomized Controlled Trial Publisher

Summary: Does ketamine improve recovery after surgery? A trial found subcutaneous ketamine delayed rescue pain medicine but increased early pain and extubation time. #Anesthesia #PainManagement

Honarmand A ; Mahmoodkhani M ; Nazemroaya B ; Ahmadian A
Authors

Source: Archives of Anesthesiology and Critical Care Published:2026


Abstract

Background: This randomized controlled trial evaluated the analgesic effect of adding subcutaneous ketamine to bupivacaine in lumbar fusion surgery. Methods: 46 adult patients were randomized to receive subcutaneous bupivacaine with or without ketamine before incision. Pain scores (VAS), time to first rescue analgesia, opioid use, extubation time, and patient satisfaction were assessed. Results: The ketamine group had higher early postoperative pain (30 and 60 min; P < 0.05) but showed prolonged time to rescue analgesia (P = 0.037) and reduced opioid use (not statistically significant). Extubation time was significantly longer. Satisfaction scores were similar. Conclusion: Subcutaneous ketamine delayed opioid use but increased early pain and extubation time. It may be considered in selected patients, pending further research. Copyright © 2026 Tehran University of Medical Sciences.
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