Effects of Esketamine on Acute Abdominal Pain After TACE in Patients With Hepatocellular Carcinoma
Status:
Not yet recruiting
Trial end date:
2023-07-30
Target enrollment:
Participant gender:
Summary
Pain is the main complication after TACE(Transcatheter Arterial Chemoembolization) for
hepatocellular carcinoma, and its pathogenesis is not clear.The pain may be related to
partial liver tissue swelling after blocking the tumor blood supply artery embolization
agent, transient hepatic swelling causing tension or strain on the liver capsule, and
chemical irritation by the anticancer drug-Lipiodol mixture,the inadvertent embolization of
normal organs and individual sensitivity to pain. Ketamine produces anesthetic and analgesic
effects mainly by inhibiting NMDA receptor(N-methyl-D-aspartic acid receptor), and previous
studies have shown that low concentrations of ketamine have obvious analgesic effects. Not
only that, ketamine also produces analgesic effects by inhibiting opioid receptors via
G-protein coupling. In addition, ketamine can bind to monoaminergic receptors in the central
and peripheral nervous system, showing an anticholinergic effect and producing an
antispasmodic effect. Ketamine also inhibits inflammatory pain by reducing nitric oxide
production by inhibiting nitric oxide synthase. Esketamine is about three to four times more
potent than ketamine. Therefore,esketamine requires a lower dose, about half the dose of
ketamine, to produce anesthetic and analgesic effects, with fewer side effects.
Phase:
Phase 4
Details
Lead Sponsor:
The Second Affiliated Hospital of Chongqing Medical University