Comparison of Ketamine and Pregabalin on Postoperative Opioid Usage and Pain Management in Spinal Fusion: Systematic Review and Network Meta-analysis.
Michael Coffin, Muhammad Zain Azhar, Walker Shepherd et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the efficacy of ketamine versus pregabalin in reducing postoperative opioid consumption and managing pain in adults undergoing spinal fusion. The analysis included 13 randomized trials with 879 participants. Ketamine was associated with a significant reduction in 0-24-hour opioid use compared to pregabalin 150 mg, with a mean difference of -56.99 mg MME (95% CI -99.56 to -14.43).
Key findings
- Ketamine reduced 0-24-hour opioid use by 56.99 mg MME compared to pregabalin 150 mg.
- Control group had a mean difference of +21.31 mg MME in opioid use compared to pregabalin 150 mg.
- Control group reported higher pain levels than pregabalin 150 mg with a mean difference of +0.84 on the VAS.
- Adverse events were infrequent and similar across all groups.
Why it matters
Understanding the comparative effectiveness of ketamine and pregabalin in postoperative pain management can help clinicians optimize opioid-sparing strategies, potentially reducing opioid-related complications and improving recovery outcomes in spinal fusion patients.