A Randomized, Double-blind, Placebo-controlled, Study to Identify the Opioid-sparing Effects, and Pain-reduction Potential of Low Dose Ketamine on Patients Undergoing TEVAR Procedures Receiving NCI
Sam Tyagi
Summary
The objective of this study is to identify the opioid-sparing effects, and pain-reduction potential of low dose, sub-dissociative ketamine on patients undergoing thoracic endovascular aortic repair (TEVAR) procedures receiving naloxone continuous infusion (NCI).
Description
Patients undergoing descending aortic repair often experience post-operative pain, and have high post operative opioid requirements. That pain is partially due to the use of naloxone continuous infusion (NCI). NCI is part of a bundled approach used in the first 48 hours post-operatively to prevent spinal cord ischemia, a devastating complication associated with surgical repair of the descending aortic. Data indicate that patients receiving NCI experience elevated post-operative pain scores and increased opioid requirements during the 48-hr post-operative NCI administration, compared to patient…
Eligibility
- Age range
- 18–90 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * willing to give informed consent * scheduled for elective thoracic aorta repair or thoracoabdominal aortic repair * requires naloxone continuous infusion for spinal prophylaxis Exclusion Criteria: * allergy to ketamine, acetaminophen, or fentanyl * diagnosis of schizophrenia * history of hydrocephalus or central nervous system mass * incarcerated individuals * pregnant or lactating individuals
Interventions
- DrugSaline
Saline infusion
- DrugKetamine
Continuous ketamine infusion at a dose of 0.2 mg/kg/hr, initiated at the induction of anesthesia and continued for 48 hours postoperatively.
Location
- University of Kentucky Medical CenterLexington, Kentucky