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Pain, AcutePhase 2NCT04061330

Comparison of Low-dose Ketamine to Opioids in the Management of Acute Pain in Patients Presenting to the Emergency Department With Long Bone Fractures

A Phase 2 study testing Ketamine and Morphine in people with Pain, Acute, run by The University of Texas Health Science Center, Houston at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The purpose of this study is to establish the feasibility of initiating a ketamine pain control protocol in the emergency department for the treatment of acute pain in patients with long bone fractures and to compare the efficacy of the ketamine pain protocol to bolus morphine for pain control in the first 6 hours of… Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Pain, Acute
What is being tested?
Ketamine and Morphine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited States
Study dates
1 Jan 2022to 31 Dec 2022
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • patients presenting to the ED with long bone fracture, open or closed.Long bone fractures include:humerus, radius, ulna, femur, tibia, fibula.

Who cannot join

  • Received morphine in the ED prior to enrollment
  • Received ketamine any time prior to enrollment
  • Glasgow Coma Scale(GCS) less than 15
  • Transferred from other facility
  • Other moderate to severe trauma injuries
  • Contraindication to ketamine
Show all 9Show fewer
  • Cannot consent (no intubation, airway issues, hemodynamic instability)
  • Prisoners
  • Suspected and/or confirmed pregnancy

Trial locations and contacts

1 site in 1 country.

United States1 site
  • The University of Texas Health Science Center at Houston

    Houston, Texas, 77030

Other trials in United States

About this study

The purpose of this study is to establish the feasibility of initiating a ketamine pain control protocol in the emergency department for the treatment of acute pain in patients with long bone fractures and to compare the efficacy of the ketamine pain protocol to bolus morphine for pain control in the first 6 hours of patient stay in the emergency department.

Conditions
Pain, Acute
Being tested
Ketamine, Morphine
Medical subject headings
Acute Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • KetamineDrug

    Initial bolus of ketamine 0.3 mg/kg IV (maximum 30 mg) followed by ketamine infusion of 0.25mg/kg/hr (maximum 25mg/kg/hr) for 6 hours or until patient leaves the emergency department (ED),whichever occurs first.

  • MorphineDrug

    Bolus doses of morphine 0.1 mg/kg (maximum 8 mg) intravenously every 2 hours for 6 hours or until patient leaves the ED, whichever occurs first.

Study groups in NCT04061330
Study groupRoleWhat they receive
Ketamine GroupExperimentalNot described
Receives: Drug: Ketamine
Opioid groupActive comparatorNot described
Receives: Drug: Morphine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: baseline

  2. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 5 minutes after initial administration of drug

  3. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 10 minutes after initial administration of drug

  4. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 30 minutes after initial administration of drug

  5. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 60 minutes after initial administration of drug

  6. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 2 hours after initial administration of drug

  7. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 3 hours after initial administration of drug

  8. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 4 hours after initial administration of drug

  9. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 5 hours after initial administration of drug

  10. Clinical pain as assessed by the Numerical pain rating score (NPRS)

    The NPRS total score ranges form 0-10,0 being no pain and 10 being worst possible pain.

    Measured: 6 hours after initial administration of drug

Secondary outcomes (33)
  1. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 5 minutes after initial administration of drug

  2. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 10 minutes after initial administration of drug

  3. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 30 minutes after initial administration of drug

  4. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 60 minutes after initial administration of drug

  5. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 2 hours after initial administration of drug

  6. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 3 hours after initial administration of drug

  7. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 4 hours after initial administration of drug

  8. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 5 hours after initial administration of drug

  9. Number of hypoxic episodes as measured with a continuous pulse oximeter

    Hypoxic episodes occur when peripheral capillary oxygen saturation (SPO2) is less than 90 percent as measured by a continuous pulse oximeter.

    Measured: 6 hours after initial administration of drug

  10. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 5 minutes after initial administration of drug

  11. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 10 minutes after initial administration of drug

  12. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 30 minutes after initial administration of drug

  13. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 60 minutes after initial administration of drug

  14. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 2 hours after initial administration of drug

  15. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 3 hours after initial administration of drug

  16. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 4 hours after initial administration of drug

  17. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 5 hours after initial administration of drug

  18. Number of hypotension episodes

    Hypotension occurs when systolic blood pressure (SBP) is less than 100mmHg

    Measured: 6 hours after initial administration of drug

  19. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 5 minutes after initial administration of drug

  20. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 10 minutes after initial administration of drug

  21. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 30 minutes after initial administration of drug

  22. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 60 minutes after initial administration of drug

  23. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 2 hours after initial administration of drug

  24. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 3 hours after initial administration of drug

  25. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 4 hours after initial administration of drug

  26. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 5 hours after initial administration of drug

  27. Score on Richmond Agitation-Sedation Scale (RASS)

    The RASS is a 10-point scale ranging from +4 to -5, with four levels of anxiety or agitation (+4 to +1), one level denoting a calm and alert state (0), and 5 levels of sedation (-1 to -5). +4 represents a very combative, violent patient, and on the other extreme -5 represents a patient who is unarousable, with no response to voice or physical stimulation.

    Measured: 6 hours after initial administration of drug

  28. Number of participants with need for rescue opioid therapy

    Measured: from time of initial administration of drug to end of treatment (about 6 hours after initial administration of drug)

  29. Number of participants with need for rescue benzodiazepine therapy in ketamine group for emergence phenomenon and dysphoria

    Measured: from time of initial administration of drug to end of treatment (about 6 hours after initial administration of drug)

  30. Number of participants with Adverse reactions

    Measured: from time of initial administration of drug to end of treatment (about 6 hours after initial administration of drug)

  31. Patient satisfaction with analgesia

    Patient satisfaction will be measured on a 5 point scale, with 1 being very unsatisfied and 5 being very satisfied.

    Measured: end of treatment (about 6 hours after initial administration of drug)

  32. Physician satisfaction with analgesia

    Physician satisfaction will be measured on a 5 point scale, with 1 being very unsatisfied and 5 being very satisfied.

    Measured: end of treatment (about 6 hours after initial administration of drug)

  33. Nursing satisfaction with analgesia

    Nursing satisfaction will be measured on a 5 point scale, with 1 being very unsatisfied and 5 being very satisfied.

    Measured: end of treatment (about 6 hours after initial administration of drug)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Aug 2019
  2. Study start1 Jan 2022 (estimated)
  3. Primary completion31 Dec 2022 (estimated)
  4. Study completion31 Dec 2022 (estimated)

Why it stopped: Study was terminated prior to enrollment due to lack of funding

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04061330
Sponsor's protocol ID
HSC-MS-19-0580
Status last verified
Apr 2022
First submitted
15 Aug 2019
Last updated
27 Apr 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ketamine and Morphine in people with Pain, Acute, run by The University of Texas Health Science Center, Houston at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 27 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical pain as assessed by the Numerical pain rating score (NPRS) (time frame: baseline). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2022.

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