Oral Sedation During Cervical Dilator Placement (OSDI)

March 10, 2020 updated by: Johns Hopkins University

Oral Sedation During Cervical Dilator Placement: A Randomized Controlled Trial

This will be a randomized, double-blind, placebo-controlled trial involving 2 arms. It will be comparing the effects of placebo compared to 1 mg oral lorazepam/5 mg oral oxycodone on pain scores during cervical dilator placement prior to dilation and evacuation (D&E).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Potential participants will be first introduced to the study via routine intake call. Participants will be identified at the participant's office visits to the Johns Hopkins' Women's Center for Family Planning. If a patient desires D&E for a second trimester pregnancy, the patient will first receive standard counseling. Only after providing written informed consent for the procedure will the patients be screened for eligibility in the study. If the patient is eligible the participant will be asked by a member of the research team if the patient is interested in participating. If the patient is, the study will be explained to the participant and written consent will be obtained after participant is given the opportunity to have all questions answered.

The study is randomized, double-blind, placebo-controlled trial involving 2 arms. Participants will first complete a survey to collect demographic data.

Participants in both arms will receive the institution's current standard analgesia for cervical dilator placement. In addition to this standard regimen, participants will be randomized to receive either: (1) a dose of two oral placebo pills, or (2) 1mg of oral lorazepam with 5 mg of oral oxycodone prior to cervical dilator placement.

Study Type

Interventional

Enrollment (Actual)

27

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Maryland
      • Baltimore, Maryland, United States, 21224
        • Johns Hopkins' Women's Center for Family Planning

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 50 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Women aged 18-50 years
  • English speaking
  • With an intrauterine pregnancy (either viable or non-viable) between the gestational ages of 17w0d and 23w6d
  • Have a support person present with participant
  • Have a cell phone capable of text messaging (optional)

Exclusion Criteria:

  • Non-English-speaking
  • Taking a daily benzodiazepine or opiate
  • Have a known allergy or contraindication to NSAIDs, opiates, or benzodiazepines

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Placebo Arm
Two oral placebo pills (microcrystalline cellulose capsules)
Placebo oral pills
Active Comparator: Active Drug Arm: Lorazepam and Oxycodone
1 mg of oral lorazepam and 5 mg of oral oxycodone (also encased in microcrystalline cellulose capsules)
Oxycodone and Lorazepam
Other Names:
  • Ativan
  • Roxicodone
  • OxyIR
  • Oral Oxycodone
  • Oral Lorazepam

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cervical Dilator Placement Pain as Assessed by VAS on a Tablet Device
Time Frame: Immediately after the last dilator is placed, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
Immediately after the last dilator is placed, up to 1 minute

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Desired Number of Dilators Inserted
Time Frame: After speculum removed, up to 30 minutes
Assess whether desired number of dilators was not able to be successfully inserted, comparing 2 arms.
After speculum removed, up to 30 minutes
Baseline Pain Score Before Drugs Were Administered
Time Frame: pain score given prior to administration of study drugs, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
pain score given prior to administration of study drugs, up to 1 minute
Pain Score Before Speculum Placement
Time Frame: pain score given before specula placed, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
pain score given before specula placed, up to 1 minute
Pain Score After Speculum Placement
Time Frame: pain score given at time of speculum placement, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
pain score given at time of speculum placement, up to 1 minute
Pain Score at Tenaculum Placement
Time Frame: Immediately scored at time of tenacula placement, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
Immediately scored at time of tenacula placement, up to 1 minute
Pain Score During Paracervical Block
Time Frame: pain score given at time of paracervical block administration, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
pain score given at time of paracervical block administration, up to 1 minute
Pain Score After First Dilator Placement
Time Frame: pain score given immediately after first dilator placed, up to 1 minute
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever)
pain score given immediately after first dilator placed, up to 1 minute
Pain Score 15 Minutes After Last Dilator Placed
Time Frame: Assessed up to 45 minutes after last dilator placed
Compare pain scores on a 100 mm visual analog scale (VAS) (anchors 0=no pain; 100=worst pain ever). This was to be assessed at 15 minutes after last dilator is placed. Some participants had this assessment done up to 45 minutes after last dilator was placed because it could not be done at 15 minutes (some were being attended to by a nurse at the 15 minutes mark).
Assessed up to 45 minutes after last dilator placed

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Carolyn Sufrin, Johns Hopkins University
  • Principal Investigator: Jessica K Lee, MD, Johns Hopkins University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 28, 2017

Primary Completion (Actual)

May 28, 2019

Study Completion (Actual)

May 28, 2019

Study Registration Dates

First Submitted

June 27, 2017

First Submitted That Met QC Criteria

June 27, 2017

First Posted (Actual)

June 28, 2017

Study Record Updates

Last Update Posted (Actual)

March 30, 2020

Last Update Submitted That Met QC Criteria

March 10, 2020

Last Verified

March 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • IRB00117627

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The study plans to share placebo data (without PHI) with colleagues at University of California Davis at the end of the study. A Memorandum of Understanding will be created prior to sharing (MOU) and data will be shared across a secure server.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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