Management of Pain in Lumbar Arthrodesis

NCT ID: NCT04751175

Last Updated: 2024-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

128 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-04

Study Completion Date

2025-12-31

Brief Summary

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KETAMINE AND DEXAMETASONE IN THE MANAGEMENT OF PAIN IN LUMBAR ARTHRODESISPhase IV prospective randomized controlled single-center clinical trial to determine the effect of intravenous ketamine and dexamethasone administration perioperatively in patients undergoing lumbar arthrodesis.

Detailed Description

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The need to carry out this study is to evaluate the analgesic effects after the administration of ketamine and dexamethasone intravenously perioperatively in patients undergoing lumbar arthrodesis and, likewise, study the incidence of pain and protocolize perioperative analgesia.

Conditions

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Pain, Postoperative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Single-center, controlled, prospective and randomized clinical trial, phase IV, to determine the effect of perioperative intravenous administration of ketamine and dexamethasone in patients undergoing lumbar arthrodesis
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
To preserve the masking of the study, the randomization system has been carried out by the pharmacy service personnel using the EPIDAT 4.0 program and only the personnel responsible for the pharmacy will know the randomization tables and codes. The main investigator will have the emergency codes in case of need by contacting the pharmacy service

Study Groups

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Ketamina bolus plus Dexamethasone bolus plus infusion ketamine

Ketamine bolus (0.5 mg / kg) + dexamethasone 0.1 mg / kg bolus + ketamine infusion (0.1 mg / kg / h) up to three hours after admission to the Post-Anesthesia Resuscitation Unit (URPA)

Group Type EXPERIMENTAL

Ketamine

Intervention Type DRUG

Ketamine, being a non-competitive antagonist of NMDA receptors, could represent a good option as an opioid treatment enhancer for acute postoperative pain and avoid chronic pain, by reducing the '' wind-up '' phenomenon of central sensitization

Dexamethasone

Intervention Type DRUG

A meta-analysis published in September 2011 affirms that the administration of dexamethasone at a dose of 0.1 mg / kg is an effective complement to multimodal analgesia strategies to reduce postoperative pain and opioid consumption after surgery.

Preoperative administration of the drug produces a more consistent analgesic effect than intraoperative administration

Ketamine bolus plus ketamine infusion

Ketamine bolus (0.5 mg / kg) + physiological serum bolus + ketamine infusion (0.1 mg / kg / h) up to three hours after admission to the URPA.

Group Type EXPERIMENTAL

Ketamine

Intervention Type DRUG

Ketamine, being a non-competitive antagonist of NMDA receptors, could represent a good option as an opioid treatment enhancer for acute postoperative pain and avoid chronic pain, by reducing the '' wind-up '' phenomenon of central sensitization

Physiologic saline

Intervention Type DRUG

placebo

Dexametasone arm

Saline bolus + dexamethasone bolus 0.1 mg / kg + saline infusion up to three hours after admission in URPA

Group Type ACTIVE_COMPARATOR

Dexamethasone

Intervention Type DRUG

A meta-analysis published in September 2011 affirms that the administration of dexamethasone at a dose of 0.1 mg / kg is an effective complement to multimodal analgesia strategies to reduce postoperative pain and opioid consumption after surgery.

Preoperative administration of the drug produces a more consistent analgesic effect than intraoperative administration

Physiologic saline

Intervention Type DRUG

placebo

Saline bolus

Saline bolus + saline bolus + saline infusion up to three hours after admission to the URPA

Group Type PLACEBO_COMPARATOR

Physiologic saline

Intervention Type DRUG

placebo

Interventions

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Ketamine

Ketamine, being a non-competitive antagonist of NMDA receptors, could represent a good option as an opioid treatment enhancer for acute postoperative pain and avoid chronic pain, by reducing the '' wind-up '' phenomenon of central sensitization

Intervention Type DRUG

Dexamethasone

A meta-analysis published in September 2011 affirms that the administration of dexamethasone at a dose of 0.1 mg / kg is an effective complement to multimodal analgesia strategies to reduce postoperative pain and opioid consumption after surgery.

Preoperative administration of the drug produces a more consistent analgesic effect than intraoperative administration

Intervention Type DRUG

Physiologic saline

placebo

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Male or female
* Age\> 18 years
* ASA I-III.
* Lumbar arthrodesis.
* Patients who have signed the preoperative informed consent for participation in the study.

Exclusion Criteria

* Unstable coronary heart disease
* Glaucoma
* History of allergy to ketamine, dexamethasone, or morphic chloride
* Dementia or inability to understand IC and study
* Pluricomplicated diabetes mellitus difficult to control
* Patients who have taken an experimental drug 30 days before the start of the study or who are included in any type of study of an experimental drug
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta

OTHER

Sponsor Role lead

Responsible Party

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Dr Emili Leon

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Emili Leon, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital Dr Josep Trueta and Hospital Santa Caterina

Locations

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Hospital Dr Josep Trueta

Girona, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Cristina Martinez, Sc

Role: CONTACT

972940200 ext. 2343

Emili Leon, MD

Role: CONTACT

972940200

Facility Contacts

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Cristina Martinez, MSc

Role: primary

972940200 ext. 2343

Other Identifiers

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EudraCT number 2012-002518-38

Identifier Type: -

Identifier Source: org_study_id

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