Chronic Pain Clinical Trial
Official title:
The Effect of Intraoperative Ketamine on Opioid Consumption and Pain After Spine Surgery in Opioid-dependent Patients
Patients with a daily use of opioids may develop higher postoperative pain levels, often need high doses of morphine and therefore their pain may be difficult to treat. A low dose of an old anesthetic drug, ketamine, administered during surgery can possibly reduce pain and morphine consumption in these patients. Our purpose is to investigate the effect of low dose ketamine on morphine consumption and pain after spine surgery in patients with a daily use of opioids. Our hypothesis is that low dose ketamine can reduce morphine consumption, pain and side-effects after spine surgery.
Opioid-dependent patients can develop hyperalgesia and often have a high opioid consumption
postoperatively due to opioid tolerance. Intraoperative ketamine in subanesthetic doses can
possibly reduce hyperalgesia and reduce opioid-tolerance in these patients. Ketamine is a
non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist that works by blocking the
NMDA receptors in the central and peripheral nerve system. It can be used for general
anesthesia but the drug also has other properties including lowering of central excitability
and reducing postoperative opioid tolerance by modeling the opioid receptors. Further more
it can possibly reduce chronic pain by blocking wind-up effect when blocking the NMDA
receptors.
Our purpose is to investigate the effect of intraoperative ketamine on opioid consumption
and pain after spine surgery in opioid-dependent patients. Our hypothesis is that ketamine
can reduce opioid consumption and reduce postoperative pain and side effects compared to
placebo.
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