The Effect of Preprocedural Subanesthetic Ketamine on Pain and Anxiety

Procedural Pain Clinical Trial

Official title:

The Effect of Preprocedural Subanesthetic Ketamine for Pain and Anxiety in Patients During Thoracic Epidural Catheterization: A Randomized Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT06310850
• Other study ID #: KEAH-238
• Status: Completed
• Phase: Phase 3
• Start date: June 1, 2013
• Est. completion date: June 1, 2023

Study information

• Verified date: March 2024
• Source: Ankara Ataturk Sanatorium Training and Research Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The thoracic epidural catheterization (TEC) can be both uncomfortable and fearful for patients when done awake with the thought that the procedure may be painful. The aim of this study was to assess the effect of subanesthetic intravenous ketamine administration on pain and anxiety during the TEC procedure.

Description:

The study aimed to assess the impact of subanesthetic intravenous ketamine administration on pain and anxiety during Thoracic Epidural Catheterisation (TEC) procedure, which can be uncomfortable and frightening for patients when performed awake due to the possibility of pain. After receiving approval from the clinical research ethics committee of Keçiören Education and Research Hospital (KEAH; ID:238), this prospective and randomized study will include 60 adult patients with ASA physical status I-III who are scheduled for elective thoracic surgery via thoracotomy. The study will randomly assign patients into two groups: Group P (n=30) receiving an intravenous placebo and Group K (n=30) receiving intravenous (IV) 0.15 mg kg-1 ketamine. Randomisation will be performed using a computerised table of random numbers. Patients with chronic pain, bleeding disorders, drug use, liver disease, severe metabolic and endocrine problems, a history of ketamine or local anaesthetic allergy, infection at the site of intervention, or refusal of TEC will be excluded. Patients who report acute pain during preoperative evaluation, have a TEC time of more than five minutes (from needle insertion to catheter insertion), and require more than two Tuohy needle attempts will be excluded. Vital parameters and anxiety levels of each patient will be recorded before premedication. Anxiety (VAS-A) and pain (VAS-P) scores will be measured using the visual analogue scale. Patients will be transported to the operating theatre 20 minutes after premedication. Intravenous administration of 0.15 mg/kg IV ketamine or placebo will take place 3 minutes before TEC placement.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 60
• Est. completion date: June 1, 2023
• Est. primary completion date: January 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients who underwent elective thoracic surgery via thoracotomy
• Patients with ASA physical status I-III

Exclusion Criteria:

• Describing chronic pain,
• Have a bleeding disorder,
• Having a history of analgesia drug use,
• Have a history of liver disease,
• Have serious metabolic and endocrine problems,
• Have a history of allergy to ketamine and local anesthetics,
• Have an infection in the intervention area,
• Rejecting thoracic epidural catheter,
• Describing acute pain in any part of the body during the preoperative evaluation,
• Thoracic epidural catheter duration greater than five minutes (time from needle entry to catheter placement)
• Patients requiring more than two Tuohy injection attempts

Related Conditions & MeSH terms

• Pain, Procedural
• Procedural Pain
• Thoracic

Intervention

Drug:
• Ketamine
Patients will be administered 0.15 mg kg-1 intravenous ketamine (The sample provided contains equal proportions of two enantiomers, S and R ketamine hydrochloride.) 3 minutes before thoracic epidural catheter placement.

Other:
• Placebo
Intravenous saline will be administered to patients 3 minutes before the thoracic epidural catheter is placed.

Locations

Country	Name	City	State
Turkey	Ankara Atatürk Sanatorium Training and Research Hospital	Ankara	Keçiören

Sponsors (1)

Lead Sponsor	Collaborator
Ankara Ataturk Sanatorium Training and Research Hospital

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Visual analog scale (VAS)	For anxiety, on a 100 mm scale, 0 mm was defined as no anxiety, whereas 100 mm was as unbearable anxiety (VAS-A). A similar scoring method was used to assess pain intensity. 0 mm was defined as no pain and 100 mm as unbearable pain (VAS-P).	1 day (5 times)