Intraoperative S-ketamine for the reduction of opioid consumption and pain one year after spine surgery: A randomized clinical trial of opioid-dependent patients
| Autor: | Rikke Vibeke Nielsen, Ole Mathiesen, Jørgen B. Dahl, J. S. Fomsgaard, Lone Nikolajsen |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Visual analogue scale Population Analgesic Placebo Drug Administration Schedule law.invention 03 medical and health sciences 0302 clinical medicine Bolus (medicine) Randomized controlled trial Double-Blind Method 030202 anesthesiology law Medicine Humans Ketamine education Pain Measurement education.field_of_study Analgesics Pain Postoperative Intraoperative Care Morphine business.industry Perioperative Middle Aged Opioid-Related Disorders Analgesics Opioid Anesthesiology and Pain Medicine Spinal Fusion Anesthesia Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Nielsen, R V, Fomsgaard, J S, Nikolajsen, L, Dahl, J B & Mathiesen, O 2019, ' Intraoperative S-ketamine for the reduction of opioid consumption and pain one year after spine surgery : A randomized clinical trial of opioid-dependent patients ', European Journal of Pain, vol. 23, no. 3, pp. 455-460 . https://doi.org/10.1002/ejp.1317 |
| ISSN: | 1532-2149 |
| DOI: | 10.1002/ejp.1317 |
| Popis: | BACKGROUND: We aimed to explore the effect of intraoperative S-ketamine on analgesic consumption and pain one year after spine surgery in chronic opioid-dependent patients undergoing spinal fusion surgery.METHODS: Single-centre, randomized, blinded trial of 147 patients.INTERVENTION: Perioperative S-ketamine bolus 0.5 mg/kg followed by S-ketamine 0.25 mg kg-1 hr-1 infusion or placebo.MAIN OUTCOMES: Analgesic use, pain (visual analogue scale 0-100 mm [VAS]) and labour market attachment one year after surgery assessed by written questionnaires.RESULTS: Response rate was 67%. One year after surgery, the daily use of oral morphine equivalents was lower in the ketamine group versus the placebo group: 0 (0-20) mg versus 20 (0-62) mg, (p = 0.02), and fewer patients had a daily use of any analgesics in the ketamine group versus placebo group, 42% (95% CI 23-61) versus 74% (95% CI 58-87), (p = 0.04). Mobilization pain was lower in the ketamine group compared to the placebo group: Median difference 17 mm (95% CI -30 to -3), (p = 0.02). Pain at rest was lower in the ketamine group compared to the placebo group with median difference: 13 mm (95% CI -23 to -3), (p = 0.01). Further, labour market attachment was better in the ketamine group, (p = 0.02).CONCLUSION: Intraoperative ketamine may reduce analgesic use, pain, and improve labour market attachment one year after spine surgery in a chronic opioid-dependent population.SIGNIFICANCE: This randomized clinical trial shows that intraoperative ketamine may reduce opioid use and pain and improve labour market attachment one year after spine surgery in an opioid-dependent population. |
| Databáze: | OpenAIRE |
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