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Neuropathic PainPhase 2/3MESO-SDRCNCT04650074

Effectiveness of Ketamine Administered by Mesotherapy in Complex Regional Pain Syndrome Type 1 (CRPS1)

A Phase 2/3 study testing LIDOCAINE 20 mg, LIDOCAINE 20 mg + KETAMINE 20 mg and LIDOCAINE 20 mg + KETAMINE 40 mg in people with Neuropathic Pain and Complex Regional Pain Syndrome Type 1, run by Hospices Civils de Lyon at 1 site in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Complex Regional Pain Syndrome type 1 (CRPS1) is a disabling pain syndrome. Its definitive treatment has not been established and the results of current treatments are often unsatisfactory. The prognosis is difficult to establish because the vast majority of CRPS regresses within a few weeks. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
LIDOCAINE 20 mg, LIDOCAINE 20 mg + KETAMINE 20 mg and LIDOCAINE 20 mg + KETAMINE 40 mg
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
31 participants
Where
1 siteFrance
Study dates
5 Nov 2021to 12 Jan 2024
Phase
Phase 2/3
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male / female aged ≥18 years,
  • Patient suffering from Complex Regional Pain Syndrome Type 1 (CRPS1), according to the Budapest criteria, with a neuropathic component limited to the lower or upper limbs diagnosed by the Neuropathic pain DN4 Questionnaire
  • Patient having undergone a three-stage dynamic bone scan less than 3 months old : vascular, tissue, bone, showing diffuse and extensive hyperfixation in the area suspected of CRPS1,
  • Negative urinary pregnancy test in women of childbearing age,
  • VAS (Visual Analogue Scale) > 50mm (on a scale of 0 to 100 mm) at inclusion,
  • Patients affiliated to the French social security system,
  • Writing informed consent obtained.

Who cannot join

  • Patient with the following medical history or ongoing pathologies: epilepsy, hypertension (> 180mm / 100mm Hg), unbalanced coronary artery disease, recent myocardial infarction (MDI) (less than 12 months), porphyria, hyperthyroidism, known Behçet's disease, known blood crass disorder or PT (Prothrombin Time) <20%, known psychiatric disorders, known septic osteoarticular disease,
  • Patient with HIV ((Human Immunodeficiency Viruses) infection, immunosuppression and / or immunosuppressive treatment
  • Severe heart failure,
  • History of severe allergy (angioedema),
  • Known allergies to Cr and Zn,
  • Current skin infection,
Show all 12Show fewer
  • Skin lesion next to the injection area
  • Phobia of injections,
  • Known hypersensitivity to ketamine hydrochloride or chlorobutanol,
  • Known hypersensitivity to lidocaine hydrochloride or to amide-linked local anesthetics,
  • Pregnant or breastfeeding woman
  • Patient under protective measure (safeguard measure, curatorship, guardianship) or deprived of liberty.

Trial locations and contacts

1 site in 1 country.

France1 site
  • Department of orthopedic surgery and trauma emergencies of the lower limb, Edouard Herriot Hospital, Hospices Civils de Lyon

    Lyon, 69437

Other trials in France

About this study

Official title: Pilot Study to Evaluate the Effectiveness of a Mixture of Ketamine / Lidocaine Administered by Mesotherapy in the Management of Neuropathic Pain in Complex Regional Pain Syndrome Type 1 (CRPS1). A Monocentric Randomized and Controlled Clinical Study

Complex Regional Pain Syndrome type 1 (CRPS1) is a disabling pain syndrome. Its definitive treatment has not been established and the results of current treatments are often unsatisfactory.

The prognosis is difficult to establish because the vast majority of CRPS regresses within a few weeks. However, some forms are hyperalgesic with a major chronic painful picture, very debilitating and responding poorly to treatments with possible permanent sequelae.

Read more

The management of CRPS remains difficult and unsatisfactory and is symptomatic, multidimensional and multidisciplinary involving medical, paramedical and socio-professional workers. The priority therapeutic objectives are analgesia, maintenance or gain of joint range and maintenance or restoration of motor functions. This treatment is not the subject of a consensus and its implementation is sometimes the responsibility of specialized centers such as "pain relief" centers or even Physical Medicine and Rehabilitation (MPR) structures.

Previous studies using ketamine as a treatment for CRPS1 show encouraging results with a decrease in neuropathic pain. Ketamine is a low dose pain reliever. Ketamine has been studied as an adjuvant for the treatment of chronic pain, particularly neuropathic pain. The results suggest that ketamine decreases pain intensity and reduces opioid reliance when used as an adjunct to chronic and acute pain. Ketamine is believed to have a greater analgesic effect in patients with CRPS1 compared to other chronic pain syndromes. In these studies, ketamine was used intravenously, subcutaneously, orally, intranasally, or topically.

Mesotherapy allows microdose local treatment to be carried out limiting side effects, ensuring compliance and easy to implement. The injected solutions often contain a local anesthetic (procaine or lidocaine). It allows better local tolerance from the start of treatment. In addition, through its vasodilator effect on the microcirculation, it increases the effectiveness and tolerance of other injected products.

There are no studies using ketamine administrated by mesotherapy. Based on the scientific literature, there are good reasons to believe that this treatment could be effective on the neuropathic pain of CRPS1 and well tolerated.

Being tested
LIDOCAINE 20 mg, LIDOCAINE 20 mg + KETAMINE 20 mg, LIDOCAINE 20 mg + KETAMINE 40 mg
Keywords
Complex Regional Pain Syndrome Type 1, Mesotherapy, Lidocaïne, Ketamine, Randomized clinical trial
Medical subject headings
Neuralgia, Complex Regional Pain Syndromes

What participants receive

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

  • LIDOCAINE 20 mgDrug

    4 injections (on day 1, day 7, day 14, day 28) by mesotherapy of 20 mg Lidocaine (qsp 6 ml NaCl 0.9%).

    Each mesotherapy session includes 2 steps performed chronologically. It will be done within 2 or 3 minutes each one:

    • 1st sequence: intra-epidermal injections of 3 ml by manual technique in crossed lines with a 13 mm x 0.30 needle,
    • 2nd sequence : superficial intradermal injections of 3 ml (between 1 and 2 mm) using a technique assisted by a Pistor Eliance injector at a frequency of 200 punctures per minute.
  • LIDOCAINE 20 mg + KETAMINE 20 mgDrug

    4 injections (on day 1, day 7, day 14, day 28) by mesotherapy of 20 mg Lidocaine + 20 mg Ketamine (qsp 6 ml NaCl 0.9%).

    Each mesotherapy session includes 2 steps performed chronologically. It will be done within 2 or 3 minutes each one:

    • 1st sequence: intra-epidermal injections of 3 ml by manual technique in crossed lines with a 13 mm x 0.30 needle,
    • 2nd sequence : superficial intradermal injections of 3 ml (between 1 and 2 mm) using a technique assisted by a Pistor Eliance injector at a frequency of 200 punctures per minute.
  • LIDOCAINE 20 mg + KETAMINE 40 mgDrug

    4 injections (on day 1, day 7, day 14, day 28) by mesotherapy of 20 mg Lidocaine + 40 mg Ketamine (qsp 6 ml NaCl 0.9%).

    Each mesotherapy session includes 2 steps performed chronologically. It will be done within 2 or 3 minutes each one:

    • 1st sequence: intra-epidermal injections of 3 ml by manual technique in crossed lines with a 13 mm x 0.30 needle,
    • 2nd sequence : superficial intradermal injections of 3 ml (between 1 and 2 mm) using a technique assisted by a Pistor Eliance injector at a frequency of 200 punctures per minute
Study groups in NCT04650074
Study groupRoleWhat they receive
LIDOCAINE 20 mgActive comparator4 injections (on day 1, day 7, day 14, day 28) by mesotherapy of 20 mg Lidocaine (qsp 6 ml NaCl 0.9%).
Receives: Drug: LIDOCAINE 20 mg
LIDOCAINE 20 mg + KETAMINE 20 mgExperimental4 injections (on day 1, day 7, day 14, day 28) by mesotherapy of 20 mg Lidocaine + 20 mg Ketamine (qsp 6 ml NaCl 0.9%).
Receives: Drug: LIDOCAINE 20 mg + KETAMINE 20 mg
LIDOCAINE 20 mg + KETAMINE 40 mgExperimental4 injections (on day 1, day 7, day 14, day 28) by mesotherapy of 20 mg Lidocaine + 40 mg Ketamine (qsp 6 ml NaCl 0.9%).
Receives: Drug: LIDOCAINE 20 mg + KETAMINE 40 mg

What is being measured

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

  1. Visual Analogue Scale (VAS) score

    Pain measured by VAS (Visual Analogue Scale)

    Measured: On day 0 (inclusion) and day 56 (end of patient follow-up)

Secondary outcomes (7)
  1. Evolution of the Visual Analogue Scale score

    The VAS (Visual Analogue Scale) score will be assessed at inclusion, before each mesotherapy session, and at the end of the patient follow-up

    Measured: On day 0 (inclusion), on day 1, day 7, day 14 and day 28 (mesotherapy sessions), and on day 56 (end of patient follow-up)

  2. Neuropathic Pain Symptom Inventory (NPSI) self-questionnaire score

    The Neuropathic pain will be assessed using the NPSI (Neuropathic Pain Symptom Inventory self-questionnaire) at inclusion, before each mesotherapy session, and at the patients withdrawal.

    Measured: On day 0 (inclusion), on day 1, day 7, day 14 and day 28 (mesotherapy sessions), and on day 56 (end of the patient follow-up)

  3. Brief Pain Inventory (BPI) self-questionnaire score

    The main dimensions of pain (i.e. intensity, functional disability, social and family repercussions as well as the level of psychological distress) will be assessed using the BPI (Brief Pain Inventory self-questionnaire) at inclusion and at the patients withdrawal.

    Measured: On day 0 (inclusion) and on day 56 (end of patient follouw-up)

  4. Relevant adverse events

    The relevant adverse events (AEs), as well as the average of the highest grades of the relevant adverse events, will be collected during the patient follow-up, in particular after each mesotherapy session. The physician will ask the patient at each of the visits and will report any adverse event (AE). The nature and intensity of the AE will be assessed according to the Common Terminology Criteria for Adverse Events grid (CTCAE version 5.0). Relevant adverse events (AEs at least possibly related to treatment or mesotherapy) will be considered.

    Measured: Until day 56 (end of patient follow-up)

  5. Concomitant consumption of analgesics

    The consumption of other analgesics concomitant with the treatment will be recorded

    Measured: Until day 56 (end of patient follow-up)

  6. EQ-5D-5L (EuroQol health states) questionnaire score

    The quality of life will be assessed using the EQ-5D-5L questionnaire (EuroQol health states)

    Measured: On day 1 (inclusion) and on day 56 (end of patient follow-up)

  7. Visual Analogue Scale and Adverse Events grades (Benefit / risk balance)

    To simultaneously compare the VAS (Visual Analogue Scale) and the relevant adverse events (AE) grades between groups.

    This benefit-risk balance will be estimate in a hierarchical fashion using the method of pairwise comparisons. The VAS will be used as the first endpoint (benefit) and the highest grade of AE in a given patient as the second endpoint (risk). No clinical relevance threshold will be specified for the two criteria for the primary analysis, but they will then be added as a sensitivity analysis.

    Measured: Until day 56 (end of patient follow-up)

Timeline

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

  1. First posted2 Dec 2020
  2. Study start5 Nov 2021
  3. Primary completion12 Jan 2024
  4. Study completion12 Jan 2024

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04650074
Sponsor's protocol ID
69HCL18_0996
Acronym
MESO-SDRC
Status last verified
May 2024
First submitted
25 Nov 2020
Last updated
10 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Lafuma P, Magaud L, Abichou-Klich A, Rabilloud M, Wegrzyn J, Baude C, Rippert P, Kaou M, Haesebaert J, Rongieras F, Marchand C, Dhelens C, Febvey-Combes O. Mesotherapy With Lidocaine and Ketamine in Complex Regional Pain Syndrome Type 1: A Randomized Double-Blind Trial. Pain Pract. 2026 Sep;26(7):e70187. doi: 10.1111/papr.70187.

    PubMed 42421175

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing LIDOCAINE 20 mg, LIDOCAINE 20 mg + KETAMINE 20 mg and LIDOCAINE 20 mg + KETAMINE 40 mg in people with Neuropathic Pain and Complex Regional Pain Syndrome Type 1, run by Hospices Civils de Lyon at 1 site in France.

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 7 inclusion and 12 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: finished, as of the sponsor's last update on 10 Aug 2026. 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 France. 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 combined 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.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Visual Analogue Scale (VAS) score (time frame: On day 0 (inclusion) and day 56 (end of patient follow-up)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04650074, which also lists 1 linked publication.

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 10 Aug 2026.

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