Adding ketamine to an opioid in a patient-controlled analgesia device: is it really relevant in the pediatric population?
However, studies included in this meta-analysis mixed both adults and children studies and only 2 pediatric studies were included in this meta-analysis. We have performed to date 2 meta-analyses concerning the effects of administering ketamine to children.2,3 Results displayed no evidence of a decrease in postoperative pain associated with the administration of ketamine and a slight evidence for an opioid sparing effect of this compound in this special population (0.04 mg/kg decrease of morphine consumption over the first postoperative day) when ketamine was administered during 24 hours after surgery. When applied to adult patients, this would make a decrease of 2.8 mg during the first postoperative day, while overall results displayed by the meta-analysis performed by Assouline et al. displayed a decrease of 13 mg during the first postoperative day (4.5 times greater).
We would caution, on the basis of our meta-analyses of ketamine in children, that the robustly favorable effects of ketamine in patient-controlled analgesia found in a predominantly adult population may not be seen in children.