Prevention of Persistent Postsurgical Pain After Thoracotomy

About This Study

Postthoracotomy acute pain is followed by persistent postsurgical pain in 20-30% of the patients, defined as pain that lasts more than 3-6 months after surgery. Acute pain and hyperalgesia around the surgical wound are some of the risk factors associated to the development of chronic pain. Ketamine, as a NMDA antagonist mainly at spinal level, might reduce periincisional hyperalgesia and persistent postsurgical pain after thoracotomy. Therefore, the investigators hypothesized that continuous ketamine infusion at subanesthetic dose would potentiate epidural ropivacaine and fentanyl-induced analgesia after thoracotomy, reduce periincisional hyperalgesia and long-term postoperative pain. To test these hypothesis, the investigators administered a low dose of intravenous ketamine or epidural ketamine or placebo to patients who received an epidural infusion of ropivacaine and fentanyl for postthoracotomy pain.

Conditions Studied

Interventions

• •Ketamine

Eligibility

Inclusion Criteria:

* Patients over 18 years old submitted to thoracotomy or minithoracotomy expected to be extubated in the operating room

Exclusion Criteria:

* Allergy or intolerance to ketamine, local anesthetics or opioids
* Chronic preoperative pain
* Chronic opioid treatment
* Drug addiction
* Polyneuropathy
* Ischemic cardiopathy
* Psychiatric disease

Study Locations (2)