Efficacy of Ketamine in Post Anesthesia Recovery Room

Study Overview
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Brief Summary
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Observational study to assess efficacy of IV ketamine bolus when used in the post anesthesia recovery unit for uncontrolled pain despite use of opioids.

Detailed Description
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In this observational study, the investigators will monitor all patients with significant pain after any non-cardiac surgical intervention at the University of Alberta Hospital. After receiving an adequate dose of potent opioids (hydromorphone, morphine), the participants will receive up to 0,2-0,25 mg/kg IV ketamine bolus. In our center these boluses are given with 10-20mg increments. The adequate dose of opioids will be determined by the attending anesthesiologist, depending on what patients received intraoperatively and on their comorbidities. Pain scores will be assessed before and after administration of this drug. The incidence of any side effect after ketamine administration will be documented.

Official Title
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Observational Study of the Efficacy of Ketamine for Rescue Analgesia in the Post Anesthesia Recovery Room

Conditions
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Pain, Postoperative, Ketamine Adverse Reaction, Pain, Refractory, Pain, Intractable, Pain, Acute

Intervention / Treatment
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* Drug: Ketamine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients undergoing non cardiac surgery at University of Alberta Hospital meeting the following criteria: age ≥ 18 significant pain despite narcotics used in post-anesthesia care unit ketamine ordered by attending anesthesiologist Exclusion Criteria: Patient refusal to receive ketamine Patients undergoing cardiac surgery Patients who received no narcotics Contra-indication to receiving ketamine (determined by attending anesthesiologist)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with significative post-operative pain despite<br>Patients with significant pain despite receiving narcotics in PACU will receive a bolus dose of IV ketamine to assess its efficacy for pain score reduction. Bolus doses are given by 10mg IV increments, to reach approximate dose of 0,25mg/kg. | Drug: Ketamine<br>* IV ketamine - 10mg bolus may be repeated repeated 2-3 times depending on clinical judgement<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduction in pain score after ketamine use in PACU | The Numeric Rating Scale (NRS-11) is an 11-point scale for patient self-reporting of pain. It is what is used most often in our recovery room for pain assessment. A score of 0/10 means no pain, and 10/10 means worst pain. | in the immediate post-operative period in recovery room | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of side effects after ketamine use |  | in the immediate post-operative period in recovery room | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain score reduction, reduction in pain scores, post-operative pain, ketamine use in recovery room, recovery room, ketamine recovery, ketamine rescue