A Promising Route for Established Indications: A Systematic Review of Nebulized Ketamine in Pain.
Neveen A Kohaf, Tabia Imtiyaz Khan, Hamada Hamdy Elbana, Ro'A Azzam Hassouna, Mohamed Maher Abd Elfattah, Prashant Nasa, Sahar Shekoohi, Alan David Kaye, Islam Mohammad Shehata
Current Pain and Headache Reports April 30, 2025 DOI: 10.1007/s11916-025-01394-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Intervention | nebulized ketamine |
| Topics | Esketamine Ketamine |
| Keywords | Icu Nebulized ketamine Trauma Pain management Emergency medicine Drug delivery systems Anesthesiology Innovative treatments |
| Citations | 1 |
| Key findings | Nebulized ketamine appears to be a safe and efficacious treatment for acute pain, but further investigations are needed to determine its pharmacokinetics, optimal dosing, and efficacy across different populations. |
Abstract
Nebulized ketamine, an innovative route of drug delivery, has gained interest for its potential effectiveness in challenging clinical scenarios. The objective of this systematic review is to provide insights into the safety and effectiveness of nebulized ketamine in pain management. A systematic search was performed on online databases including WOS, Cochrane, Scopus, and PubMed, using a specific search strategy. Our review focused on primary studies about the utilization of nebulized ketamine in various contexts regarding pain management. Additionally, we incorporated relevant secondary research, such as reviews presenting diverse perspectives. Nebulized ketamine in pain management included nine studies. The advantages of nebulized ketamine over other forms of administration include its rapid absorption and effective delivery. The smaller volume required for nebulization can result in fewer side effects and enhanced patient compliance thereby facilitating efficient drug delivery while minimizing the systematic impact. Emerging evidence supports the administration of nebulized ketamine as a safe and efficacious treatment for acute pain. However, further investigations are needed for a better understanding of its pharmacokinetics, optimal dosing and efficacy across different populations.
Comparable studies
Other systematic reviews and meta-analyses on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis Depressed patients with suicidal ideation at baseline | 2017 | Systematic review and individual participant data meta-analysis | n = 167 |
| Ketamine use: a review Ketamine users | 2011 | Systematic review | |
| Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression Participants with major depression in placebo-controlled, double-blind, randomized... | 2015 | Systematic review and meta-analysis | |
| Ketamine and postoperative pain – a quantitative systematic review of randomised trials Surgical patients from 25 countries | 2004 | Systematic review | n = 2,839 |
| Side-effects associated with ketamine use in depression: a systematic review. Patients with depression | 2018 | Systematic review |
Citations in the library
Cites 6
- Pharmacokinetics and Bioavailability of Inhaled Esketamine in Healthy Volunteers Anesthesiology July 30, 2017
- The Possible Application of Ketamine in the Treatment of Depression in Alzheimer’s Disease Neurology International June 23, 2022
- Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of emergency medicine October 1, 2024
- Ketamine Infusion for Complex Regional Pain Syndrome Treatment: A Narrative Review. Current Pain and Headache Reports January 14, 2025
- Promoting the Discussion of the Beneficial Effects of Ketamine to Treat Refractory Depression Psychopharmacology Bulletin August 12, 2025
and 1 more in the library