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Meta-Analysis
. 2021 Oct 22;100(42):e27409.
doi: 10.1097/MD.0000000000027409.

Influence of ketamine versus fentanyl on pain relief for pediatric orthopedic emergencies: A meta-analysis of randomized controlled studies

Jin Qiu  1 , Mian Xie
Affiliations
Meta-Analysis

Influence of ketamine versus fentanyl on pain relief for pediatric orthopedic emergencies: A meta-analysis of randomized controlled studies

Jin Qiu et al. Medicine (Baltimore). .

Abstract

Introduction: The comparison of ketamine with fentanyl for pain control of pediatric orthopedic emergencies remains controversial. We conduct a systematic review and meta-analysis to explore the influence of ketamine versus fentanyl on pain management among pediatric orthopedic emergencies.

Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials assessing the effect of ketamine versus fentanyl on pain management for pediatric orthopedic emergencies.

Results: Five randomized controlled trials are included in the meta-analysis. Overall, compared with fentanyl for pediatric orthopedic emergencies, ketamine led to similar change in pain scores at 15 to 20 minutes (standard mean difference = -0.05; 95% confidence interval [CI] = -0.38 to 0.28; P = .77) and 30 minutes (standard mean difference = 0.11; 95% CI = -0.20 to 0.42; P = .49), as well as rescue analgesia (RR = 0.90; 95% CI = 0.54 to 1.51; P = .69), but revealed the increase in nausea/vomiting (RR = 2.65; 95% CI = 1.13 to 6.18; P = .02) and dizziness (RR = 3.83; 95% CI = 1.38 to 10.60; P = .01).

Conclusions: Ketamine may be similar to fentanyl in terms of the analgesic efficacy for pediatric orthopedic emergencies.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of study searching and selection process.
Figure 2
Figure 2
Forest plot for the meta-analysis of pain score change at 15–20 min.
Figure 3
Figure 3
Forest plot for the meta-analysis of pain score change at 30 min.
Figure 4
Figure 4
Forest plot for the meta-analysis of rescue analgesia.
Figure 5
Figure 5
Forest plot for the meta-analysis of nausea/vomiting.
Figure 6
Figure 6
Forest plot for the meta-analysis of dizziness.
See this image and copyright information in PMC

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