Trial reportBMC anesthesiology2026
Increasing dose of esketamine for supplemental analgesia after complex spinal fusion surgery: a randomized and double-blind trial.
Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06062550 (Efficacy of Different Dose Esketamine and Dexmedetomidine Combination for Supplemental Analgesia After Scoliosis Correction Surgery), which is not on this map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Efficacy of Different Dose Esketamine and Dexmedetomidine Combination for Supplemental Analgesia After Scoliosis Correction Surgery: A Randomized, Double-blind Trial
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Authors and funding
5 authors.
Funding
Abstract
backgroundComplex spinal surgery is associated with significant trauma and pain. Herein we tested the hypothesis that increasing the dose of esketamine, as a supplement to patient-controlled analgesia, might improve pain relief after extensive spinal surgery.
methodsIn this randomized, double-blind, and controlled trial, we enrolled adults who were scheduled to undergo extensive posterior spinal fusion. Participants were randomized in a 1:1:1 ratio to receive patient-controlled sufentanil-dexmedetomidine analgesia supplemented with esketamine at 0.25 (Esk25), 0.5 (Esk50), or 0.75 (Esk75) mg/ml. Our primary endpoint was an integrated index of pain intensity and opioid consumption (ranging from - 200% to + 200%, with higher scores indicating greater pain and/or more opioid consumption) with movement within 72 h after surgery.
resultsA total of 312 patients (median 38 years; 24.4% female) were enrolled and randomized; all were included in the intention-to-treat analysis. The primary endpoint did not differ among three groups (Esk50 vs. Esk25: mean difference - 2 [95% CI -31 to 28]; Esk75 vs. Esk25: mean difference 13 [95% CI -16 to 43]. The proportions reporting nausea/vomiting and nausea were higher in the Esk75 group than in the Esk25 group (nausea/vomiting: 70.2% [73/104] with Esk75 vs. 52.9% [55/104] with Esk25; P = 0.021; nausea: 68.3% [71/104] with Esk75 vs. 49.0% [51/104] with Esk25; P = 0.005).
conclusionsFor adult patients recovering from extensive posterior spinal fusion, increasing esketamine concentration in patient-controlled analgesia from 0.25 to 0.5 and 0.75 mg/ml did not improve pain relief or reduce opioid consumption. Esketamine at a concentration of 0.75 mg/ml increased postoperative nausea and vomiting.
trial registrationClinicalTrials.gov, NCT06062550; first submitted on September 25, 2023.
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