Ketamine in Modern Medicine: Current Evidence in Acute Pain, Opioid Use Disorder, and Depression.

Ketamine has continued to be a valuable adjunct in perioperative care, supported by recent meta-analyses demonstrating opioid-sparing effects and improved analgesia, particularly in opioid-tolerant patients and painful surgeries. Its use should be targeted to patients most likely to benefit from its unique properties. Beyond acute pain, ketamine shows promise in patients with opioid use disorder by mitigating tolerance and withdrawal through N-methyl-d-aspartate receptor modulation and downstream neuroadaptive effects. Additionally, its established antidepressant properties position ketamine as a potentially advantageous agent for patients with coexisting pain and mood disorders, a population frequently encountered in perioperative practice.