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Phase 3 Completed N=672 Randomized Quadruple-blind Prevention

The Prevention of Delirium and Complications Associated With Surgical Treatments Multi Center Clinical Trial

Source: ClinicalTrials.gov NCT01690988 ↗
Enrolled (actual)
672
Serious AEs
0.0%
Results posted
May 2018
Primary outcomePrimary: Number of Patients With Incidence of Delirium Across All Patients at Baseline and Over Post-operative Days 1-3 — 85; 43 Participants — p=0.912
◆ Published Evidence
Highly cited
496citations · ~55 / year
Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial.
Lancet (London, England) · 2017 · Open access · High-confidence link

Summary

Delirium is a medical term or condition that includes a temporary inability to focus attention and to think clearly. Delirium occurs commonly (10% to 70%) in patients older than 60 undergoing large surgeries. The purpose of this study is to test rigorously whether a drug called ketamine can decrease the chance that patients will experience delirium after their surgery. The investigators are also testing whether ketamine decreases postoperative pain, postoperative opioid consumption, postoperative nausea and vomiting, ICU and hospital length of stay, and adverse outcomes (e.g. hallucinations and nightmares).

Linked Publications (4)

  • Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial.
    Lancet (London, England) · 2017 · 496 citations · Open access · High-confidence link
  • Intraoperative ketamine for prevention of depressive symptoms after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial.
    British journal of anaesthesia · 2018 · 77 citations · Open access · Likely link
  • The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study: protocol for an international multicentre randomised controlled trial.
    BMJ open · 2014 · 38 citations · Open access · Likely link
  • Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial.
    Anesthesia and analgesia · 2019 · 18 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Patients With Incidence of Delirium Across All Patients at Baseline and Over Post-operative Days 1-3
85; 43 0.912
SECONDARY
Daily Maximum Pain Recorded
70; 63.5; 68; 56; 59; 57.5 0.964
SECONDARY
Median Opioid Consumption
88.9; 94.7; 78.7 0.476
SECONDARY
Number of Patients With Postoperative Nausea and Vomiting
72; 73; 64 0.572
SECONDARY
ICU and/or Hospital Length of Stay
SECONDARY
Adverse Outcomes (Number of Patients With Hallucinations)
45; 40; 62 0.01 sig
SECONDARY
Adverse Outcomes (Number of Patients With Nightmares)
27; 18; 34 0.03 sig

Eligibility Criteria

Inclusion Criteria

  • Patients 60 and older
  • Competent to provide informed consent
  • Undergoing major surgery (e.g., open cardiac surgery, open or thoracoscopic thoracic surgery, abdominal surgery, open urological surgery, open gynecological surgery, major orthopedic surgery, major vascular surgery including endovascular procedures, major ear, nose and throat surgery).

Exclusion Criteria

  • Patients with an allergy to ketamine
  • Those in whom a significant elevation of blood pressure would constitute a serious hazard (e.g., pheochromocytoma, aortic dissection)
  • Unable to provide informed consent
  • Patients with drug misuse history (e.g., ketamine, cocaine, heroin, amphetamine, methamphetamine, MDMA, phencyclidine, lysergic acid, mescaline, psilocybin)
  • Patients taking anti-psychotic medications (e.g., chlorpromazine, clozapine, olanzapine, risperidone, haloperidol, quetiapine, risperidone, paliperidone, amisulpride, sertindole)
  • Patients with a weight outside the range 50 kg - 200 kg (110 lbs - 440 lbs)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01690988) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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