Clinical trial NCT04701008: Efficacy of Ketamine in Post Anesthesia Recovery Room
Official title: Observational Study of the Efficacy of Ketamine for Rescue Analgesia in the Post Anesthesia Recovery Room
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Pain, Postoperative
Ketamine Adverse Reaction
Pain, Refractory
Pain, Intractable
Pain, Acute
Keywords: pain score reduction
reduction in pain scores
post-operative pain
ketamine use in recovery room
recovery room
ketamine recovery
ketamine rescue
Lead sponsor: University of Alberta
Sponsor class: OTHER
First posted: 2021-01-08
Enrollment: 143
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The following patients will be identified and recruited at the post-anesthesia care unit:

Adult patients undergoing non-cardiac surgery at University of Alberta Hospital meeting the following criteria:

1. age ≥ 18
2. significant pain despite narcotics used in post anesthesia care unit
3. ketamine ordered by attending anesthesiologist

Brief summary: 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: 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.

Eligibility criteria: 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)

Primary outcomes:
measure: Reduction in pain score after ketamine use in PACU
timeFrame: in the immediate post-operative period in recovery room
Secondary outcomes:
measure: Incidence of side effects after ketamine use
timeFrame: in the immediate post-operative period in recovery room
Other outcomes:
Locations:
city: Edmonton
country: Canada
facility: University of Alberta Hospital
state: Alberta
Study officials:
References:
citation: Brinck EC, Tiippana E, Heesen M, Bell RF, Straube S, Moore RA, Kontinen V. Perioperative intravenous ketamine for acute postoperative pain in adults. Cochrane Database Syst Rev. 2018 Dec 20;12(12):CD012033. doi: 10.1002/14651858.CD012033.pub4.
citation: Gillies A, Lindholm D, Angliss M, Orr A. The use of ketamine as rescue analgesia in the recovery room following morphine administration--a double-blind randomised controlled trial in postoperative patients. Anaesth Intensive Care. 2007 Apr;35(2):199-203.
citation: Weinbroum AA. A single small dose of postoperative ketamine provides rapid and sustained improvement in morphine analgesia in the presence of morphine-resistant pain. Anesth Analg. 2003 Mar;96(3):789-795. doi: 10.1213/01.ANE.0000048088.17761.B4.