Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Intraoperative ketamine reduces immediate postoperative opioid consumption after spinal fusion surgery in chronic pain patients with opioid dependency: a randomized, blinded trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Lasmiditan inhibits calcitonin gene-related peptide release in the rodent trigeminovascular system

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Neck pain and headache after whiplash injury: a systematic review and meta-analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Itch sensitization? A systematic review of studies using quantitative sensory testing in patients with chronic itch

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. CACNG2 polymorphisms associate with chronic pain following mastectomy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Postoperative pain, analgesia, and recovery-bedfellows that cannot be ignored

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Association between transfusion of blood products and acute kidney injury following cardiac surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Brain resting-state connectivity in the development of secondary hyperalgesia in healthy men

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Perioperative handling of surgical patients with opioid dependency represents an important clinical problem. Animal studies suggest that ketamine attenuates central sensitization and hyperalgesia and thereby reduces postoperative opioid tolerance. We hypothesized that intraoperative ketamine would reduce immediate postoperative opioid consumption compared with placebo in chronic pain patients with opioid dependency undergoing lumbar spinal fusion surgery. Primary outcome was morphine consumption 0 to 24 hours postoperatively. Secondary outcomes were acute pain at rest and during mobilization 2 to 24 hours postoperatively (visual analogue scale), adverse events, and persistent pain 6 months postoperatively. One hundred fifty patients were randomly assigned to intraoperative S-ketamine bolus 0.5 mg/kg and infusion 0.25 mg·kg·h or placebo. Postoperatively, patients received their usual opioids, paracetamol and IV patient-controlled analgesia with morphine. In the final analyses, 147 patients were included. Patient-controlled analgesia IV morphine consumption 0 to 24 hours postoperatively was significantly reduced in the ketamine group compared with the placebo group: 79 (47) vs 121 (53) mg IV, mean difference 42 mg (95% confidence interval -59 to -25), P < 0.001. Sedation was significantly reduced in the ketamine group 6 and 24 hours postoperatively. There were no significant differences regarding acute pain, nausea, vomiting, hallucinations, or nightmares. Back pain at 6 months postoperatively compared with preoperative pain was significantly more improved in the ketamine group compared with the placebo group, P = 0.005. In conclusion, intraoperative ketamine significantly reduced morphine consumption 0 to 24 hours after lumbar fusion surgery in opioid-dependent patients. The trend regarding less persistent pain 6 months postoperatively needs further investigation.

OriginalsprogEngelsk
TidsskriftPain
Vol/bind158
Udgave nummer3
Sider (fra-til)463-470
ISSN0304-3959
DOI
StatusUdgivet - mar. 2017

ID: 52351394