Dexmedetomidine-esketamine Combination and Chronic Postsurgical Pain After Spinal Surgery

Starting soon · Phase 4 · Has a placebo group

Conditions studied: Spinal Surgery, Pain Intensity, Dexmedetomidine, Esketamine, Postoperative Analgesia

In brief

Spinal surgery is generally followed by severe postoperative pain, and poor pain control may cause adverse outcomes such as cardiovascular events, neurocognitive disorders, and chronic postsurgical pain (CPSP). In previous studies, perioperative use of dexmedetomidine or esketamine is each associated with improved analgesia after surgery. Recent studies suggest that combined use of dexmedetomidine and esketamine may produce synergetic effects in improving analgesia. This trial is designed to test the hypothesis that perioperative combined use of dexmedetomidine and esketamine may reduce CPSP in patients after spinal surgery.

Key facts

Study ID

NCT07525999

Run by

Peking University First Hospital

People needed

274

Starts

2026-04-01

Expected to finish

2027-12-01

Last updated by the study team

2026-04-16

Who can join

Age: 40 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Aged >= 40 years and < 80 years;
• Scheduled to undergo elective posterior cervical, thoracic or lumbar spine surgery under general anesthesia, with an expected operative duration >= 2 hours;
• Requirement for patient-controlled intravenous analgesia (PCIA) postoperatively.

You may not qualify if…

• Severe uncontrolled hypertension preoperatively (baseline ward blood pressure: SBP > 180 mmHg or DBP > 110 mmHg);
• Severe bradycardia (heart rate <= 50 bpm), sick sinus syndrome, atrioventricular block of grade II or higher without pacemaker implantation, or a history of myocardial infarction within one year, severe heart failure (NYHA class >= III), or rapid ventricular arrhythmia;
• Preoperative history of schizophrenia, epilepsy, Parkinson's disease, myasthenia gravis, or intracranial hypertension;
• Preoperative history of hyperthyroidism or pheochromocytoma;
• Inability to communicate preoperatively due to coma, severe dementia, or language impairment;
• Severe cardiac insufficiency (preoperative LVEF < 30% or NYHA class IV), severe hepatic dysfunction (Child-Pugh class C), severe renal dysfunction (preoperative dialysis), or ASA physical status >= grade IV;
• Other conditions deemed inappropriate for study participation by the investigator or attending physician.

Where it is running

• Peking University First Hospital — Beijing, Beijing Municipality, China

Full record on ClinicalTrials.gov

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