comparison of the Effectiveness of pre-operative intravenous ketamine administration with placebo in controlling post-operative pain in patients with advanced knee osteoarthritis undergoing total knee arthroplasty

Tehran University of Medical Sciences0 个研究点目标入组 60 人开始时间: 待定最近更新: 2022年5月2日

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•Between 18 and 85 years old
•undergoing unilateral, primary total knee arthroplasty TKA for degenerative end-stage osteoarthritis(OA) of the knee (score of >2 on Kellgren-Lawrence scale).

•patients who refuse to participate,
•classified as ASA IV or V by the American Society of Anesthesiologists,
•body mass index greater than 40 kg/m2,
•rheumatoid arthritis,
•contraindication or allergy to opioid pain medications
•allergy to amide or sulpha anesthetics,
•unable to understand the visual analog scale (VAS) ,
•any preoperative ketamine or chronic narcotic usage (>10mg systemic morphine equivalents daily ) as it causes opioids tolerance ,
•those who are discharged before the first 24 hours postoperatively,
•previous history of knee arthroplasty,
•prior surgery on the ipsilateral knee within 6 months,
•simultaneous bilateral arthroplasty,
•the patients receiving general anesthesia or a nerve block
•patients with an ejection fraction of less than 30%,
•creatinine clearance of less than 30mL/min,
•chronic liver disease,
•any neurologic or psychiatric disorder (including bipolar,post-traumatic stress disorder, schizophrenia),
•chronic alcohol abuse

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