An Exploratory Study of Esketamine in Patients After Thoracoscopic Surgery
Status:
Not yet recruiting
Trial end date:
2023-06-30
Target enrollment:
Participant gender:
Summary
Thoracic surgery can produce severe postoperative acute pain, which can easily lead to cough
weakness, atelectasis, respiratory restriction, pneumonia, hypoxemia, secretion retention,
respiratory failure and other adverse events. Esketamine can reduce the demand of analgesic
opioids, reduce the respiratory depression caused by opioids, improve ventilation,
significantly reduce postoperative pain and prolong the analgesic time after thoracic
surgery. Therefore, the application of esketamine in postoperative analgesia of patients
undergoing thoracoscopic surgery may help to improve the respiratory function of clinical
patients and further improve the postoperative analgesia effect, so as to achieve the purpose
of accelerating the surgical rehabilitation of patients undergoing thoracoscopic surgery.
Esketamine is rarely used in perioperative period in China, and the development of its safe
and reasonable application methods and potential role in perioperative anesthesia needs
further research and verification. Generally speaking, at present, there is still a lack of
evaluation of ketamine in improving respiratory function, pain, anxiety and depression after
thoracoscopic surgery, and there is no direct clinical evidence.
At present, sufentanil is the most commonly used drug for postoperative analgesia in patients
undergoing clinical surgery. As a strong opioid, although sufentanil can provide good
analgesic effect, the respiratory depression caused by sufentanil is not conducive to the
recovery of postoperative lung function in patients undergoing thoracic surgery. The action
sites of esketamine include N- methyl-aspartic acid (NMDA) receptor, opioid receptor,
monoamine receptor, M cholinergic receptor, sodium channel, calcium channel, etc., which can
relieve respiratory depression caused by opioids, stimulate respiration, relax airway smooth
muscle, prevent hyperalgesia caused by opioids, reduce the dosage of postoperative analgesics
and prolong the duration of postoperative analgesia. Therefore, esketamine is likely to
improve postoperative respiratory function of patients after thoracoscopic surgery and play a
good role. To sum up, this study is intended to include patients undergoing elective
thoracoscopic surgery. Through a prospective randomized controlled double-blind clinical
trial, different analgesic drugs of intravenous patient-controlled analgesia and simple
conventional opioid analgesic sufentanil are used as the control. Combined with the
investigation of preoperative and postoperative tidal volume, oxygenation index,
postoperative pain and postoperative recovery outcome, the effects of esketamine on
postoperative respiratory function, postoperative pain and overall rehabilitation of these
patients are compared, so as to provide direct clinical evidence for improving postoperative
lung function of patients undergoing elective thoracoscopic surgery, and at the same time,
provide a choice for thoracoscopic surgery.
To explore the effect of esketamine on improving postoperative respiratory function, pain,
depression and anxiety and overall rehabilitation of patients undergoing thoracoscopic
surgery. Compound esketamine is used for postoperative analgesia, thus providing direct
clinical evidence for improving postoperative pulmonary function of patients undergoing
elective thoracoscopic surgery, and providing reference for improving postoperative pain,
anxiety and depression of patients undergoing elective thoracoscopic surgery.
Phase:
Phase 4
Details
Lead Sponsor:
The Second Affiliated Hospital of Chongqing Medical University