Low Dose Ketamine Study on Opioid Tolerance and Hyperalgesia

Brief Summary

The purpose of this study is to: 1. Establish whether ketamine can decrease opioid consumption and modulate the onset of opioid tolerance and prevent opioid-induced hyperalgesia in pediatric subjects, ages 10 years to 18 years, undergoing posterior spinal fusion and instrumentation.

Intervention / Treatment

  • Ketamine (DRUG)
    ketamine 0.5mg/kg intravenous (IV) load followed by an intraoperative continuous infusion at 0.25mg/kg/h and a postoperative infusion at 0.1mg/kg/h
  • Normal saline (DRUG)
    Normal saline given 0.5mg/kg intravenous (IV) load followed by an intraoperative continuous infusion at 0.25mg/kg/h and a postoperative infusion at 0.1mg/kg/h

Condition or Disease

  • Idiopathic Scoliosis
  • Spondylolisthesis

Phase

  • Phase 4
  • Study Design

    Study type: INTERVENTIONAL
    Status: Completed
    Study results: No Results Available
    Age: 10 Years to 18 Years
    Enrollment: 54 (ACTUAL)
    Funded by: Other
    Allocation: Randomized
    Primary Purpose: Prevention

    Masking

    QUADRUPLE:
    • Participant
    • Care Provider
    • Investigator
    • Outcomes Assessor

    Clinical Trial Dates

    Start date: Jan 01, 2010
    Primary Completion: May 01, 2012 ACTUAL
    Completion Date: Sep 01, 2012 ACTUAL
    Study First Posted: Mar 29, 2011 ESTIMATED
    Results First Posted: Nov 01, 2015 ESTIMATED
    Last Updated: Dec 14, 2015

    Sponsors / Collaborators

    Lead Sponsor: Julia Finkel
    Responsible Party: Julia Finkel

    Participant Groups

    • Normal Saline given 0.5mg/kg intravenous (IV) load followed by an intraoperative continuous infusion at 0.25mg/kg/h and a postoperative infusion at 0.1mg/kg/h

    • ketamine 0.5mg/kg intravenous (IV) load followed by an intraoperative continuous infusion at 0.25mg/kg/h and a postoperative infusion at 0.1mg/kg/h

    Eligibility Criteria

    Sex: All
    Minimum Age: 10
    Maximum Age: 18
    Age Groups: Child / Adult
    Healthy Volunteers: Yes

    Inclusion Criteria:

    1. The subject is 10 to 18 years of age
    2. The subject's American Society of Anesthesiologists physical status is ASA 1, 2 or 3 (see appendix I)
    3. The subject is scheduled for elective posterior spinal fusion and instrumentation.
    4. The subject's parent/legally authorized guardian has given written informed consent to participate

    Exclusion Criteria:

    1. The subject has a history or a family (parent or sibling) history of malignant hyperthermia
    2. The subject is pregnant or nursing.
    3. The subject has known significant renal disorders determined by medical history, physical examination or laboratory tests
    4. The subject has a known or suspected allergy to morphine, remifentanil or ketamine
    5. The subject is an ASA classification of 4 or greater (See Appendix I)
    6. The subject is scheduled for a surgical sub-procedure (i.e. anterior spinal fusion)
    7. The subject is unable to self-administer morphine using patient-controlled analgesia (PCA) pump
    8. The subject had a recent opioid exposure (within 1 month of surgery)
    9. The subject is obese (body mass index \>30kg/m2)
    10. The subject is planned for elective postoperative ventilation
    11. The subject has a known ocular disease not permitting pupillometric examination
    12. The subject has used any investigation products in the past 30 days

    Primary Outcomes
    • Morphine consumption (mg/kg) was measured over time in the Ketamine group and compared to the Control (saline) group. Values are for each 24 hour time period and displayed as hours post surgery.

    Secondary Outcomes
    • Sedation scores 0 = completely awake 1. = sleepy but responds appropriately 2. = somnolent but arouses to light stimuli 3. = asleep but responsive to deeper physical stimuli 4. = asleep and not responsive to any stimuli Values are for each 24 hour time period and displayed as hours post surgery.

    • Patient volunteered response at rest, 1-10 scale (where a higher score indicates more pain and a lower score indicates less pain). Values are for each 24 hour time period and displayed as hours post surgery.

    • Patient volunteered response during a cough, 1-10 scale (where a higher score indicates more pain and a lower score indicates less pain). Values are for each 24 hour time period and displayed as hours post surgery.

    More Details

    NCT Number: NCT01325493
    Acronym: KPSF
    Other IDs: 4735
    Study URL: https://clinicaltrials.gov/study/NCT01325493
    Last updated: Sep 29, 2023