Analgesic Effect of Esketamine in DCSB in Adultscontrolled Study
Status:
Not yet recruiting
Trial end date:
2025-05-31
Target enrollment:
Participant gender:
Summary
Patients with severe and above degree burns are often complicated with inhalation injury and
systemic infection. During debridement and dressing change in such patients, doctors will be
more cautious in using analgesics. Patients often moan, shiver and limb movement due to
insufficient sedation and analgesia, resulting in unpleasant feelings and experiences, which
increases the anxiety of patients during hospitalization. Previous studies have shown that
the use of ketamine in burn patients during dressing change can produce good analgesia and
maintain stable vital signs.
Esketamine, the dextral monomer of ketamine, has hypnotic, sedative and analgesic effects and
could be safely used in clinical anesthesia. Compared with ketamine, esketamine has stronger
analgesic efficacy and less circulatory influence, which is more consistent with the
characteristics of ideal analgesic drugs in burn dressing. As an FDA-approved drug for the
treatment of refractory depression, esketamine has potential social benefits in burn patients
due to its rapid antidepressant pharmacological properties. This study hypothesized that
esketamine could reduce the pain of dressing change in patients with severe burns and reduce
the occurrence of early depression in such patients.
This study adopted a prospective, double-blind, randomized, controlled, single-center design.
A total of 52 severe burn patients aged 18-60 years who need debridement and dressing change
under sedation and analgesia were included and randomly divided into the experiment group:
esketamine would be used in the induction phase; the control group: esketamine would not be
used in the induction phase. Both groups were given dexmedetomidine and butofinol before
induction, and fentanyl as a remedy during the dressing change phase. The dosage of fentanyl
in the dressing change phase, the pain score (SF-MPQ) after recovery, the incidence of
sedation-related complication were compared between the two groups.
This study explores the advantages of esketamine in reducing the use of opioids and the pain
score of patients.