Comparison Between Low-dose Ketamine Infusion and Intravenous Morphine

Brief Summary

Ketamine is an antagonist of N-methyl-d-aspartate (NMDA) receptor that not only abolishes peripheral afferent noxious stimulation, but it may also prevent central sensitization of nociceptors as shown in animal studies with excellent analgesic property even in subanesthetic doses. It is readily available and is being used currently, even by non-Anesthesiologists, to provide "sedation" for minor procedures.(.. Low-dose ketamine infusion in the perioperative period has shown to produce analgesia and decrease the requirements of opioid analgesics.. In obstetrics, it is being used as an adjunct to an inadequately functioning spinal anesthesia for caesarean section, as an induction agent for cesarean section and also to provide analgesia during labor in intermittent boluses.

Intervention / Treatment

  • Ketamine group: (DRUG)
    Ketamine group: will be administered ketamine in a loading dose of 0.2 mg/kg over 5 min pre incision followed-by an infusion at 0.2 mg/kg/h until the end of surgery.
  • Control group (DRUG)
    where normal saline was administered as a loading dose then infused with same rate of another group, throughout the whole surgery.

Condition or Disease

  • Ketamine

Phase

  • Phase 4
  • Study Design

    Study type: INTERVENTIONAL
    Status: Completed
    Study results: No Results Available
    Age: 18 Years to 50 Years
    Enrollment: 80 (ACTUAL)
    Funded by: Other
    Allocation: Randomized
    Primary Purpose: Diagnostic

    Masking

    DOUBLE:
    • Participant
    • Care Provider

    Clinical Trial Dates

    Start date: Feb 21, 2019 ACTUAL
    Primary Completion: May 20, 2020 ACTUAL
    Completion Date: Jun 20, 2020 ACTUAL
    Study First Posted: Feb 24, 2020 ACTUAL
    Results First Posted: Aug 31, 2020
    Last Updated: Jul 28, 2020

    Sponsors / Collaborators

    Lead Sponsor: Cairo University
    Responsible Party: N/A

    Location

    Ketamine is an antagonist of N-methyl-d-aspartate (NMDA) receptor that not only abolishes peripheral afferent noxious stimulation, but it may also prevent central sensitization of nociceptors as shown in animal studies with excellent analgesic property even in subanesthetic doses. It is readily available and is being used currently, even by non-Anesthesiologists, to provide "sedation" for minor procedures.(.. Low-dose ketamine infusion in the perioperative period has shown to produce analgesia and decrease the requirements of opioid analgesics.. In obstetrics, it is being used as an adjunct to an inadequately functioning spinal anesthesia for caesarean section, as an induction agent for cesarean section and also to provide analgesia during labor in intermittent boluses.

    Participant Groups

    • control group: where normal saline will be administered as a loading dose then infused with same rate of another group, throughout the whole surgery.

    • Ketamine group: will be administered ketamine in a loading dose of 0.2 mg/kg over 5 min pre incision followed-by an infusion at 0.2 mg/kg/h until the end of surgery.

    Eligibility Criteria

    Sex: Female
    Minimum Age: 18
    Maximum Age: 50
    Age Groups: Adult
    Healthy Volunteers: Yes

    Inclusion criteria:

    The study will include 80 ASA physical status I, II patients with age between 18- 50 years old scheduled for elective myomectomy under general anesthesia

    Exclusion criteria:

    Patients who refused to participate, ASA physical status III, IV, patients younger than 18 years or \> 50 years old, BMI \> 30, history of epilepsy. Patients having a history of parenteral or oral analgesics within the last 24 hours before initiation of operation or those having allergy to study agents will be excluded.

    -

    Primary Outcomes
    • adjusted to keep the HR and mean arterial blood pressure within 20% of the pre induction values. Starting from the induction till the end of the operation.

    Secondary Outcomes
    • time from start to end

    • assessment of patient by VAS sore 0= no pain , 10= sever pain

    • complication

    • complication

    • complication

    • complication

    More Details

    NCT Number: NCT04281628
    Other IDs: I-190414
    Study URL: https://clinicaltrials.gov/study/NCT04281628
    Last updated: Sep 29, 2023