Different Dose Esketamine and Dexmedetomidine for Supplemental Analgesia and Longterm Outcomes
Status:
Not yet recruiting
Trial end date:
2026-12-01
Target enrollment:
Participant gender:
Summary
Chronic postsurgical pain (CPSP) refers to pain that occurs or increases after surgery and
lasts longer than 3 months. Severe acute postoperative pain is one of the major risk factors
of CPSP. Spinal correction surgery is associated with severe pain due to large trauma and
long duration. Ketamine and esketamine are N-methyl-D-aspartate receptor antagonists; they
have antihyperalgesic effects and may reduce CPSP. Dexmedetomidine is an alpha 2-adrenoceptor
agonist with sedative, anxiolytic, and analgesic effect; it is frequently used as an adjuvant
to postoperative analgesia. In a previous trial of 200 patients after scoliosis correction
surgery, mini-dose esketamine-dexmedetomidine in combination with opioids significantly
improved analgesia and sleep quality but did not reduce CPSP. The authors speculate that
increasing esketamine dose in the combination may further improve analgesia and, therefore,
reduce the occurrence of CPSP.