The following is a summary of “Patient safety of adjunct pre-operative intravenous S-ketamine for pain relief in third molar surgery – a randomised, placebo-controlled, double-blind trial,” published in the June 2024 issue of Pain by Eriksson, et al.

Researchers conducted a retrospective study to assess the impact of two S-ketamine dosages on patient safety during third molar surgery. They compared the dosages with placebo and evaluated changes in SpO₂, respiratory rate, blood pressure, pulse, and AEs.

They involved 168 participants, and two subanesthetic doses of S-ketamine were administered: low (0.125 mg/kg) and high (0.25 mg/kg). Each patient received midazolam sedation before receiving the study drug. Teeth were extracted using standard clinical procedures and local anesthesia.

The results showed that capillary oxygen saturation (SpO ₂) post-investigational drug administration was the primary safety endpoint. A significant difference (P=.021) was observed between the placebo and high-dose groups, indicating decreased saturation in the high-dose group. The incidence of SpO ₂ <90% and the lowest saturation did not differ between groups. Approximately 40% of cases received oxygen supplementation, with no variation between intervention groups. No other significant differences were found in saturation or respiratory rate between groups.

Investigators concluded that the safety profile of S-ketamine for third molar surgery remained unclear, as the higher dose (0.25mg/kg) decreased oxygen saturation compared to placebo.

Source: journals.sagepub.com/doi/10.1177/20494637241262509