Marie Rahme

Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

School of Nursing

Department

Nursing

Date of Original Version

12-1-2019

Abstract

Pain in the postoperative period is a serious issue that can have a negative physical and emotional impact on patient outcomes. Complications from postoperative pain can have detrimental outcomes for patient’s health and wellbeing as well as the increased economic burden of continued treatment. Better management of pain in the perioperative phase can result in improved patient outcomes, fewer postoperative complications, and increased patient satisfaction. Although opioids are the mainstay of treatment in the perioperative period for pain management, abnormal pain responses such as hyperalgesia may be induced by administration of opioids. The purpose of this systematic review is to examine the effect of ketamine on reducing the phenomenon of opioid-induced hyperalgesia. After a comprehensive literature search, the PRISMA Statement was used to frame this systematic review and elevate the validity of the results by providing transparency and clarity of the findings. The theoretical framework that guided this systematic review was Melzack and Wall’s (1965) Gate Control Theory of Pain which encompassed the physiologic and emotional responses of pain. Studies incorporated in this systematic review were critically appraised to evaluate reliability of randomized control trials. Variables such as intraoperative doses of opioids, intraoperative ketamine doses, postoperative pain scores, postoperative opioid consumption, and evidence of hyperalgesia were evaluated and put into tables for comparison. The results of this systematic review support the use of ketamine in decreasing postoperative opioid consumption, decreasing postoperative pain scores, and decreasing the incidence of opioid induced hyperalgesia.

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