Analgesic Efficacy of Intravenous Ketamine as a Continuous Infusion vs PCA in the Management of Acute Postoperative Pain in Major Orthopedic Surgery: A Randomized Clinical Trial

What this Trial Is About

Researchers are evaluating how to best manage pain after major orthopedic surgery in adults. This clinical trial compares two ways of giving ketamine, a pain-relieving medicine: a continuous intravenous infusion versus a patient-controlled analgesia (PCA) pump. The study aims to see if continuous infusion is as effective as PCA for pain control and if it reduces the need for opioid pain medicines within the first 24 hours after surgery. Participants will be randomly assigned to one of two groups. One group receives ketamine through a continuous infusion starting at surgical closure, with specific dosing for 48 hours. The other group uses a PCA pump delivering a mix of ketamine and morphine, allowing patients to control their doses with limits set by the pump for up to 48 hours. Both groups have access to rescue morphine via PCA if needed. The trial is designed to be triple-blind, ensuring unbiased results. During the first three days after surgery, researchers will visit participants in the hospital to assess pain levels and monitor side effects. Various outcomes will be measured, including pain at rest and with movement, opioid use, time to walking, length of hospital stay, nausea, sedation, delirium, and vital signs. Participants may be followed for up to 36 months to assess long-term outcomes such as hospital stay duration and recovery. The total treatment and observation period is focused on the initial 72 hours after surgery.

Analgesic Efficacy of Intravenous Ketamine as a Continuous Infusion vs PCA in the Management of Acute Postoperative Pain in Major Orthopedic Surgery.