Status:

COMPLETED

Ketamine to Improve Recovery After Cesarean Delivery - Part 1

Lead Sponsor:

Grace Lim, MD, MS

Collaborating Sponsors:

University of Pittsburgh

Conditions:

Obstetric Pain

Postpartum Depression

Eligibility:

FEMALE

18-99 years

Phase:

PHASE2

Brief Summary

The objective of this study is evaluate the breastmilk transfer and pharmacokinetics (Part 1) and effectiveness (Part 2) of a post-cesarean delivery intravenous ketamine bolus-and-infusion strategy, a...

Detailed Description

Postpartum pain management strategies currently permit opioids for breakthrough pain, but strategies focused on minimizing or eliminating opioids are lacking. In the non-obstetric surgical population,...

Eligibility Criteria

Inclusion

  • Adult female patients (i.e., ≥18 years of age) and able to provide informed consent
  • Cesarean Delivery, Scheduled or Non-Emergent (delivery within 15 minutes not necessary), or female weaning off of breastfeeding
  • Cesarean cohort: ASA PS 2 or 3, with or without E designation (delivery within 15 minutes not necessary), Scheduled or Non-Emergent
  • Spinal anesthesia with intrathecal morphine if Cesarean Delivery, Scheduled or Non-Emergent
  • Multimodal postop analgesia with IV ketorolac, PO NSAID, and PO APAP if Cesarean Delivery, Scheduled or Non-Emergent
  • Women who do not plan to breastfeed or who want to temporarily withhold breastfeeding or who are weaning off of breastfeeding (Part 1)

Exclusion

  • Cesarean Delivery under General Anesthesia
  • Allergies to study medications
  • ASA PS 4 or 4E
  • ASA PS with E designation because delivery within 15 minutes required
  • ASA PS greater than 4 (moribund patients)
  • Contraindications to spinal anesthesia
  • Contraindications to NSAIDs (gastric bypass, etc.)
  • Contraindication to any other multimodal analgesia medicine
  • Significant psychiatric history (depression and anxiety NOT exclusion criteria), uncontrolled hyperthyroidism, cardiac disease, fever, hypertension
  • Adverse occurrence during caesarean section such as hemorrhage, need for transfusion, hemodynamic instability
  • Placenta accreta spectrum or previa with large anticipated blood loss
  • History of hallucinations, alcohol or illicit substance use/abuse, chronic opioid therapy, or chronic pain (chronic pain - defined by any condition requiring consistent follow up with pain specialist or daily administration of pain medications that could augment sedative effects)
  • Pre-eclampsia with severe features

Key Trial Info

Start Date :

October 9 2019

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

August 1 2021

Estimated Enrollment :

8 Patients enrolled

Trial Details

Trial ID

NCT04037085

Start Date

October 9 2019

End Date

August 1 2021

Last Update

December 20 2022

Active Locations (2)

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Page 1 of 1 (2 locations)

1

UPMC Montefiore Hospital CTRC

Pittsburgh, Pennsylvania, United States, 15213

2

Minhnoi C Wroble Biglan

Pittsburgh, Pennsylvania, United States, 15232