Pain management · 2026
Effect of intraoperative ketamine on pain, opioid use, and psychological recovery in orthopedic trauma patients (KOPM trial): protocol for a randomized, single-blind trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Curran Camas, Hernandez Evan J, Hudnall Jennifer, Sra Jaspinder, Davis Max E
Аннотация
BACKGROUND: Orthopedic trauma patients frequently struggle with pain control, prolonged opioid use, and psychiatric co-morbidities, including depression and post-traumatic stress disorder (PTSD). Current treatment strategies inadequately address both pain and psychological recovery. Ketamine, an NMDA receptor antagonist with analgesic and psychotropic properties, has shown promise in surgical and psychiatric populations but has not been evaluated in polytraumatized orthopedic patients.
OBJECTIVES: This study evaluates ketamine's effectiveness on postoperative pain measured by the Visual Analog Scale (VAS), opioid consumption converted to morphine milligram equivalents (MME), and psychological recovery assessed with the Patient Health Questionnaire-9 (PHQ-9) and PTSD Checklist for DSM-5 (PCL-5).
METHODS: In this prospective, randomized, single-blind, active comparator study, 90 adults aged 18-65 undergoing operative fixation for orthopedic injuries at a Level I Trauma Center will receive either ketamine (0.5 mg/kg IV bolus) or standard general anesthesia without ketamine. Participants remain blinded to treatment, while surgical, anesthesia, and postoperative clinical care teams are unblinded. Outcomes will be measured at 1-7 days, 2-3 weeks, 6 weeks, 3 months, and 6 months postoperatively.
DISCUSSION: This is the first randomized controlled trial to evaluate intraoperative ketamine for both physical and psychological recovery in orthopedic trauma patients, addressing a critical gap in perioperative trauma care.
CLINICAL TRIAL REGISTRATION: The www.clinicaltrials.gov identifier is NCT06903819.
OBJECTIVES: This study evaluates ketamine's effectiveness on postoperative pain measured by the Visual Analog Scale (VAS), opioid consumption converted to morphine milligram equivalents (MME), and psychological recovery assessed with the Patient Health Questionnaire-9 (PHQ-9) and PTSD Checklist for DSM-5 (PCL-5).
METHODS: In this prospective, randomized, single-blind, active comparator study, 90 adults aged 18-65 undergoing operative fixation for orthopedic injuries at a Level I Trauma Center will receive either ketamine (0.5 mg/kg IV bolus) or standard general anesthesia without ketamine. Participants remain blinded to treatment, while surgical, anesthesia, and postoperative clinical care teams are unblinded. Outcomes will be measured at 1-7 days, 2-3 weeks, 6 weeks, 3 months, and 6 months postoperatively.
DISCUSSION: This is the first randomized controlled trial to evaluate intraoperative ketamine for both physical and psychological recovery in orthopedic trauma patients, addressing a critical gap in perioperative trauma care.
CLINICAL TRIAL REGISTRATION: The www.clinicaltrials.gov identifier is NCT06903819.