Intraoperative S-ketamine for the reduction of opioid consumption and pain one year after spine surgery: A randomized clinical trial of opioid-dependent patients.
Eur J Pain
; 23(3): 455-460, 2019 03.
Article
em En
| MEDLINE
| ID: mdl-30246357
ABSTRACT
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. MAINOUTCOMES:
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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
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Fusão Vertebral
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Analgésicos
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Cuidados Intraoperatórios
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Ketamina
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Transtornos Relacionados ao Uso de Opioides
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Dinamarca