(999) Efficacy and Safety of Ketamine for Post-Cardiac Surgery Pain Management

Introduction: There is conflicting data showing support for ketamine as adjunct pain management, with minimal data specifically in the cardiac surgery patient population. The results of this study will describe the use of ketamine in the post-cardiac surgery patient population and will elucidate the current mixed evidence of ketamine’s association with reduced opioid requirements and pain scores in the surgical population.

Methods: This was a retrospective review of adult patients 18 years of age or older who were admitted to the cardiovascular intensive care unit after index cardiovascular surgery and received continuous infusion ketamine within 24 hours after surgery completion. The primary objective of the study is to evaluate the efficacy of ketamine for pain management following cardiac surgery through the evaluation of postoperative opioid requirements.

Results: Data was collected retrospectively from September 1, 2023, until 100 subjects were collected. The primary outcomes showed a median cumulative morphine milligram equivalents (MME) of 282mg (IQR 78.75 – 653.25). When comparing pain scores pre and post-ketamine, median pain scores were higher after the initiation of ketamine (2.0 vs 3.0, p = 0.22). There was a higher opioid consumption after ketamine as seen by a pre-ketamine MME of 0 and post-ketamine MME of 232.75 (p < 0.001). However, when assessed individually, sixty-five percent of patients had a decrease in their pain scores and fourteen percent had a decrease in morphine equivalents after the initiation of ketamine.

Conclusions: The use of continuous infusion ketamine showed a reduction of pain scores but failed to show a reduction in opioid requirements in patients after cardiac surgery.