Post Operative Pain Clinical Trial
Official title:
Ketamine Improves Post-Thoracotomy Analgesia
Thoracotomy for lung tumor or for minimally invasive direct coronary artery bypass (MIDCAB) surgery, may be associated with debilitating pain. Ketamine was shown to enhance opioid antinociception and prevent opioid resistance. We hypothesize that ketamine given with morphine would lower morphine consumption and narcotic related side effects after thoracotomy and provide superior analgesia to morphine given alone.
We planned a prospective, randomomized, double blind study of 2 pain management protocols in
consecutive patients undergoing thoracotomy for MIDCAB or lung tumor resection over a 6
month period. After patients emerged from a standardized general anesthetic and when
objectively awake and complaining of pain >5/10 on a visual analogue pain scale, they were
connected to an intravenous patient controlled analgesia regimen. The regimen was assigned
randomly to be either morphine alone (1.5 mg per dose, lockout interval of 7 minutes) or
morphine plus ketamine (1.0 mg morphine plus 5 mg ketamine per dose, same lockout interval).
Rescue diclofenac was available to both groups. Follow-up lasted 4 hours.
We planned to monitor and compare pain scores, wakefulness scores, hemodynamic and
respiratory parameters as well as total morphine consumption and incidence of side effects
and complications. All monitoring and recording was done by blinded nurses and intensive
care physicians.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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