Effectiveness of ketamine as an adjuvant to opioid-based therapy in decreasing pain associated with opioid tolerance in adults undergoing orthopedic surgery: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The objective of this systematic review is to examine the best available evidence on the clinical effectiveness of ketamine as an adjuvant to opioid-based therapy versus opioid-based therapy alone in decreasing perioperative pain associated with opioid tolerance in adult patients, aged 18-70 years, undergoing orthopedic surgical procedures.The following question guides the systematic review: does the administration of ketamine as an adjuvant to opioid-based therapy, compared to opioid-based therapy alone, improve perioperative pain relief in opioid-tolerant adult patients undergoing orthopedic surgical procedures?

[1]  J. Hitt,et al.  Perioperative management of the opioid tolerant patient for orthopedic surgery. , 2014, Anesthesiology clinics.

[2]  Madhuri S. Kurdi,et al.  Ketamine: Current applications in anesthesia, pain, and critical care , 2014, Anesthesia, essays and researches.

[3]  M. Jaff,et al.  Opioid tolerance--a predictor of increased length of stay and higher readmission rates. , 2014, Pain physician.

[4]  R. Urman,et al.  Perioperative analgesia and challenges in the drug-addicted and drug-dependent patient. , 2014, Best practice & research. Clinical anaesthesiology.

[5]  James A. McGowan,et al.  Ketamine decreases postoperative pain scores in patients taking opioids for chronic pain: results of a prospective, randomized, double-blind study. , 2013, Pain medicine.

[6]  A. Salimi,et al.  Opioid-Sparing Effect of Preemptive Bolus Low-Dose Ketamine for Moderate Sedation in Opioid Abusers Undergoing Extracorporeal Shock Wave Lithotripsy: A Randomized Clinical Trial , 2013, Anesthesia and analgesia.

[7]  W. McKay,et al.  A systematic review of intravenous ketamine for postoperative analgesia , 2011, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[8]  M. Bekhit Opioid-induced hyperalgesia and tolerance. , 2010, American journal of therapeutics.

[9]  Jeremiah R. Brown,et al.  Intraoperative Ketamine Reduces Perioperative Opiate Consumption in Opiate-dependent Patients with Chronic Back Pain Undergoing Back Surgery , 2010, Anesthesiology.

[10]  M. Angst,et al.  Ketamine for managing perioperative pain in opioid-dependent patients with chronic pain: a unique indication? , 2010, Anesthesiology.

[11]  Manzo Suzuki Role of N-methyl-D-aspartate receptor antagonists in postoperative pain management , 2009, Current opinion in anaesthesiology.

[12]  Jane Y. Lipnitsky,et al.  Ketamine as an Adjunct to Postoperative Pain Management in Opioid Tolerant Patients After Spinal Fusions: A Prospective Randomized Trial , 2008, HSS journal : the musculoskeletal journal of Hospital for Special Surgery.

[13]  M. Ersek,et al.  Mechanisms of opioid-induced tolerance and hyperalgesia. , 2007, Pain management nursing : official journal of the American Society of Pain Management Nurses.

[14]  D. Sessler,et al.  The Evolution of Primary Hyperalgesia in Orthopedic Surgery: Quantitative Sensory Testing and Clinical Evaluation Before and After Total Knee Arthroplasty , 2007, Anesthesia and analgesia.

[15]  P. Lavand'homme,et al.  The clinical role of NMDA receptor antagonists for the treatment of postoperative pain. , 2007, Best practice & research. Clinical anaesthesiology.

[16]  Jane Y. Lipnitsky,et al.  Ketamine as an Adjunct to Postoperative Pain Management in Opioid Tolerant Patients After Spinal Fusions: A Prospective Randomized Trial , 2008, HSS Journal.

[17]  M. Angst,et al.  Management of Perioperative Pain in Patients Chronically Consuming Opioids , 2004, Regional Anesthesia & Pain Medicine.

[18]  M. Duncan,et al.  Analgesia with ketamine in a patient with perioperative opioid tolerance. , 2002, Journal of pain and symptom management.