EP161 Feasibility of postoperative ketamine infusion in general hospital wards without intense monitoring in chronic pain patients: A retrospective cohort study
Bibliographic record
Abstract
Background and Aims Chronic pain is prevalent and poses challenges in perioperative management. Opioid-dependent patients often require higher opioid doses and experience uncontrolled postoperative pain. Ketamine, a non-competitive NMDA-receptor-antagonist, has shown promise in reducing postoperative opioid-consumption and pain intensity. This study aims to evaluate ketamine-infusion safety and side-effects in postoperative wards and its impact on monitoring protocols, as well as its potential to reduce opioid-use in chronic opioid-dependent patients. Methods In this retrospective chart-review we compared: patients who received intraoperative and postoperative ketamine-infusion(Ketamine-Group) and patients who did not(Control-Group). Outcomes included severity of ketamine-related adverse-effects, opioid-related side-effects measured via validated 11 item scale, and length of hospital stay. Results This study included 202patients, ketamine-group(94-patients) and control-group(108-patients). No ketamine-related severe side-effects were observed in any group. Mild to moderate ketamine-related side-effects were reported in both groups, with mild-hallucinations being more frequent in the ketamine-group(p=0.006). Mild Nausea(P =0.052) and urinary-retention(p<0.001) was observed more frequently in ketamine-group. Constipation was observed more frequently in control-group(p=0.033). Ketamine-group had significantly higher median intraoperative opioid- use(p<0.001), and second 24-hour postoperative opioid-use(p=0.033). Median length of hospital stay in the ketamine-group was 174.55-hours compared to 116.66-hours in control-group(p<0.001)(table-1, figure-1). Conclusions This study demonstrated the feasibility of ketamine-infusion for postoperative opioid consumption in patients with chronic pain without 1:1 monitoring in the ICU or step-down units. The use of ketamine was not associated with any major adverse effects requiring intense resource utilization. There was no direct association between ketamine-related side-effect and increased length of hospital stay. However, the long-term effects of ketamine-infusion on postoperative pain remain to be evaluated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".