Observational study to assess efficacy of IV ketamine bolus when used in the post anesthesia recovery unit for uncontrolled pain despite use of opioids.

In this observational study, the investigators will monitor all patients with significant pain after any non-cardiac surgical intervention at the University of Alberta Hospital.

After receiving an adequate dose of potent opioids (hydromorphone, morphine), the participants will receive up to 0,2-0,25 mg/kg IV ketamine bolus. In our center these boluses are given with 10-20mg increments.

The adequate dose of opioids will be determined by the attending anesthesiologist, depending on what patients received intraoperatively and on their comorbidities.

Pain scores will be assessed before and after administration of this drug. The incidence of any side effect after ketamine administration will be documented.

Inclusion Criteria:

Adult patients undergoing non cardiac surgery at University of Alberta Hospital meeting the following criteria:

• age ≥ 18
• significant pain despite narcotics used in post-anesthesia care unit
• ketamine ordered by attending anesthesiologist

Exclusion Criteria:

• Patient refusal to receive ketamine
• Patients undergoing cardiac surgery
• Patients who received no narcotics
• Contra-indication to receiving ketamine (determined by attending anesthesiologist)

The following patients will be identified and recruited at the post-anesthesia care unit:

Adult patients undergoing non-cardiac surgery at University of Alberta Hospital meeting the following criteria:

1. age ≥ 18
2. significant pain despite narcotics used in post anesthesia care unit
3. ketamine ordered by attending anesthesiologist