Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial

Background Postoperative pain can lead to several complications. The effectiveness of different opioids in relieving pain after surgery has been widely studied. However, managing pain in patients with opioid addiction is still challenging. This study aimed to examine the impact of ketamine and metha...

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Main Authors: Elham Bakhtiari, Mehrdad Mokaram Dori, Millad Reza Darban Razavi, Andia Peivandi Yazdi, Arash Peivandi Yazdi
Format: Article
Language:English
Published: Korean Society of Anesthesiologists 2024-07-01
Series:Anesthesia and Pain Medicine
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Online Access:http://anesth-pain-med.org/upload/pdf/apm-23129.pdf
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author Elham Bakhtiari
Mehrdad Mokaram Dori
Millad Reza Darban Razavi
Andia Peivandi Yazdi
Arash Peivandi Yazdi
author_facet Elham Bakhtiari
Mehrdad Mokaram Dori
Millad Reza Darban Razavi
Andia Peivandi Yazdi
Arash Peivandi Yazdi
author_sort Elham Bakhtiari
collection DOAJ
description Background Postoperative pain can lead to several complications. The effectiveness of different opioids in relieving pain after surgery has been widely studied. However, managing pain in patients with opioid addiction is still challenging. This study aimed to examine the impact of ketamine and methadone on postoperative pain in patients with addiction. Methods This was a non-inferiority randomized clinical trial. All included patients were monitored for morphine use, pain scores, and vital signs every 3 h. The intervention group received 0.5 mg/kg ketamine administered intravenously every 6 h. The control group received 5 mg of methadone intramuscularly every 8 h. The patient received intravenous morphine if their visual analog scale was above 3. All side effects in each group were recorded. Results Two hundred and twenty patients were included in this study. There were 127 men (57.7%) with an average age of 57.1 ± 19.5 and 93 women (42.3%) with an average age of 57.1 ± 21.0. There were no significant differences in demographic characteristics between the groups. There was no significant difference in the dose or frequency of morphine administration between groups. There was no significant difference between the groups in pain scores and vital signs at different time points. Drug side effects, including delirium and gastrointestinal symptoms, did not differ significantly between the methadone and ketamine groups. Conclusions Our clinical data support the hypothesis that ketamine is not inferior to methadone in patients with addiction. Future Randomize Clinical Trials are needed to confirm these observations.
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spelling doaj-art-fefe9139269f4b74b88fa8ab11c8ccba2024-11-18T07:05:10ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772024-07-0119320921510.17085/apm.231291259Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trialElham Bakhtiari0Mehrdad Mokaram Dori1Millad Reza Darban Razavi2Andia Peivandi Yazdi3Arash Peivandi Yazdi4 Clinical Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran Department of Anesthesia, School of Medicine, Mashhad University of Medical Seince, Mashhad, Iran Department of Anesthesia, School of Medicine, Mashhad University of Medical Seince, Mashhad, Iran Dentistry Student, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran Lung Disease Research Center, Department of Anesthesiology, Mashhad University of Medicine Sciences, Mashhad, IranBackground Postoperative pain can lead to several complications. The effectiveness of different opioids in relieving pain after surgery has been widely studied. However, managing pain in patients with opioid addiction is still challenging. This study aimed to examine the impact of ketamine and methadone on postoperative pain in patients with addiction. Methods This was a non-inferiority randomized clinical trial. All included patients were monitored for morphine use, pain scores, and vital signs every 3 h. The intervention group received 0.5 mg/kg ketamine administered intravenously every 6 h. The control group received 5 mg of methadone intramuscularly every 8 h. The patient received intravenous morphine if their visual analog scale was above 3. All side effects in each group were recorded. Results Two hundred and twenty patients were included in this study. There were 127 men (57.7%) with an average age of 57.1 ± 19.5 and 93 women (42.3%) with an average age of 57.1 ± 21.0. There were no significant differences in demographic characteristics between the groups. There was no significant difference in the dose or frequency of morphine administration between groups. There was no significant difference between the groups in pain scores and vital signs at different time points. Drug side effects, including delirium and gastrointestinal symptoms, did not differ significantly between the methadone and ketamine groups. Conclusions Our clinical data support the hypothesis that ketamine is not inferior to methadone in patients with addiction. Future Randomize Clinical Trials are needed to confirm these observations.http://anesth-pain-med.org/upload/pdf/apm-23129.pdfaddictclinical trialketaminemethadonepostoperative pain
spellingShingle Elham Bakhtiari
Mehrdad Mokaram Dori
Millad Reza Darban Razavi
Andia Peivandi Yazdi
Arash Peivandi Yazdi
Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial
Anesthesia and Pain Medicine
addict
clinical trial
ketamine
methadone
postoperative pain
title Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial
title_full Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial
title_fullStr Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial
title_full_unstemmed Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial
title_short Comparison of low-dose ketamine to methadone for postoperative pain in opioid addicts: a randomized clinical trial
title_sort comparison of low dose ketamine to methadone for postoperative pain in opioid addicts a randomized clinical trial
topic addict
clinical trial
ketamine
methadone
postoperative pain
url http://anesth-pain-med.org/upload/pdf/apm-23129.pdf
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