This double-blind, placebo-controlled trial (n=1, terminated) aimed to determine whether perioperative ketamine (bolus 1 mg/kg + infusion 0.20 mg/kg/hr) increases postoperative pain tolerance and reduces opioid consumption in opioid-dependent patients undergoing spinal laminectomy/fusion.
Randomized, double-blind, placebo-controlled Phase II trial in opioid-dependent patients undergoing lumbar/thoracic/cervical spine surgery assessing perioperative ketamine (1 mg/kg IV bolus then 0.20 mg/kg/hr infusion, max 20 mg/hr).
Primary outcome: hydromorphone PCA usage in the first 72 hours postoperatively. Secondary outcomes include VAS pain scores at multiple timepoints, McGill Pain Questionnaire, Pain Catastrophizing Scale, PROMIS emotional distress measures, Neuro-QOL satisfaction with social roles, and opioid consumption converted to morphine equivalents.
Participants were recruited from the University of Pittsburgh Medical Center neurosurgery clinics and operating rooms; consent and enrollment performed by surgical team or PI with coordinator support.
Intraoperative bolus followed by postoperative continuous ketamine infusion for opioid-dependent patients undergoing spine surgery.
Bolus 1 mg/kg IV 15 minutes after induction; then infusion 0.20 mg/kg/hr (max 20 mg/hr) continued until 48 hours after surgery.
Matching saline bolus and infusion.
Saline bolus 15 minutes after induction and saline infusion matched to ketamine schedule (placebo comparator).