Postoperative Pain Clinical Trial
Official title:
Safety and Efficacy Evaluation of S(+)-Ketamine for Postoperative Acute Pain in Adults in Perioperative Settings: A Multicenter, Randomized, Open-label, Active Controlled Pragmatic Clinical Trial
A multicenter, randomized, open-label, active controlled pragmatic clinical trial that evaluates the safety and efficacy of S (+) -ketamine for postoperative acute pain in adults in perioperative settings.
Status | Not yet recruiting |
Enrollment | 12000 |
Est. completion date | June 30, 2022 |
Est. primary completion date | June 1, 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - 1. Age =18 years old; - 2. Scheduled for elective digestive tract surgery, gynecological surgery, urological surgery, thoracic surgery, orthopedic limb surgery, orthopedic spine surgery or body surface surgery (thyroid surgery or breast surgery), head and neck surgery; - 3. ASA score ?~?; - 4. The informed consent form was signed by the patients. Exclusion Criteria: - 1. The expected length of hospital stay of the patient is less than 48h; - 2. Patients expected to be admitted to the ICU after surgery; - 3. Patients expected to return to the ward with tracheal catheter after surgery; - 4. Be allergic to S (+) - ketamine; - 5. Patients with severe disorder of consciousness or mental system diseases (schizophrenia, mania, bipolar disorder, psychosis, etc.) or cognitive dysfunction; - 6. Patients with a history of severe cardiovascular disease (congestive heart failure, severe angina attack, or unstable angina or myocardial infarction within 6 months); - 7. Patients during pregnancy or lactation; - 8. Patients with MMSE score <18 points; - 9. Patients with any of the following contraindications of S (+) - ketamine: 1. Patients with risk of serious rise of blood pressure or intracranial pressure; 2. Patients with high intraocular pressure (glaucoma) or penetrating ocular trauma; 3. Patients with poorly controlled or untreated hypertension (Resting systolic blood pressure greater than 180 mmHg, or resting diastolic blood pressure greater than 100mmHg); 4. Patients with untreated or undertreated hyperthyroidism. |
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Chinese PLA General Hospital | Beijing Hospital, First Affiliated Hospital Xi'an Jiaotong University, First Affiliated Hospital, Sun Yat-Sen University, Jiangsu Provincial People's Hospital, Renmin Hospital of Wuhan University, Shengjing Hospital, Southern Medical University, China, The Affiliated Hospital of Qingdao University |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The area under the broken line of NRS score | The score of Numerical Rating Scale(NRS) is 0-10, the higher the score, the more severe the pain. | Hour 0-48 after surgery | |
Primary | Opioid consumption | Total opioid consumption(conversion to equivalent morphine) | Hour 0-48 after surgery | |
Secondary | NRS pain scores | The score of Numerical Rating Scale(NRS) is 0-10, the higher the score, the more severe the pain. | Hour 0-48 after surgery | |
Secondary | Time of first rescue analgesia | The time from the end of the operation to the first rescue analgesics after the operation. Rescue analgesia refers to the analgesia according to the patient's requirements in addition to routine postoperative analgesia. | Hour 0-48 after surgery | |
Secondary | The incidence of rescue analgesia | The incidence of rescue analgesia within 48h after surgery | Hour 0-48 after surgery | |
Secondary | Recovery time | The time from the end of the operation to recovery(can be awakened) | Day 0 | |
Secondary | The incidence of unexpected intraoperative events | Unexpected events during operation include intraoperative cough, laryngeal spasm, body movement, tachycardia,decreased oxygen saturation, respiratory depression, bradycardia, hypertension and hypotension. | Intraoperative | |
Secondary | The Patient Efficacy Questionnaire (IPOQ ) scores | Patient Efficacy Questionnaire (IPOQ ) scale include 13 questions , each question's score is 0-10 or 0-100%, it involves postoperative pain, mood and quality of life. The higher the score, the more severe the pain symptoms. | Hour 48 after surgery | |
Secondary | The incidence of adverse events after surgery | The incidence of adverse events from the end of the operation to 48h after surgery. Including nausea, vomiting, increased secretions, dizziness, oversedation, infection,anesthetic awareness, nightmares, restlessness, pruritus, disorientation, delirium, respiratory depression, diplopia, diarrhea, intestinal obstruction, urinary retention, gastroesophageal reflux, constipation, chills, hallucinations, etc. | Hour 0-48 after surgery | |
Secondary | Pharmacoeconomic indicators | Calculating incremental cost-effectiveness ratio (ICER)based on cost-effectiveness analysis. | Hour 48 after surgery | |
Secondary | Incidence of postoperative delirium | The Chinese version of the 3D-CAM scale is used for the diagnosis of delirium, and the assessment will be carried out at 24h, 48h and 72h after the operation. If the patient is discharged 72h after the patient is discharged, it may not be assessed. | Hour 0-48 after surgery | |
Secondary | Simple Mental State Examination (MMSE) Scale score | The total score of Simple Mental State Examination Scale (MMSE) is 30,the higher the score, the better the cognitive function. | Hour 48 after surgery | |
Secondary | Hospital Anxiety and Depression (HAD) Scale score | Hospital Anxiety and Depression Scale (HAD) includes anxiety measure(7questions,0-21pionts) and depression measure(7 questions,0-21pionts),the higher the score, the more severe thesymptoms. | Hour 48 after surgery |
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