- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04703803
Efficacy of Myofascial Pain Syndrome Treatment in Patients With Cancer in Palliative Care
April 22, 2023 updated by: Nereida Kilza da Costa Lima, University of Sao Paulo
Treatment of Myofascial Pain Syndrome With Lidocaine Injection in Patients With Cancer in Palliative Care: a Randomized Clinical Trial
Palliative Care is active holistic care offered to people who are in intense suffering related to their health, resulting from a serious life-threatening illness, with a focus on improving the quality of life.
Among the symptoms that cause suffering, physical pain has a prominent role in terms of prevalence and impact on well-being, especially in the subgroup of patients with terminal cancer.
Myofascial Pain Syndrome may be one of the components of pain in cancer patients in palliative care.
However, the literature is scarce in defining the prevalence of this condition in this population, and there is no evidence of the benefit of needling treatment with 1% lidocaine in these patients until now.
The objectives of this study are to determinate the prevalence of myofascial pain syndrome and to evaluate the effectiveness of myofascial pain treatment with 1% lidocaine injection in reducing pain in palliative cancer patients, comparing it with a control group in usual care.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This is a clinical trial designed as a comparative, randomized, single-blinded intervention study.
Patients will be recruited from wards and radiotherapy sector of the Ribeirão Preto Clinical Hospital - Ribeirão Preto Medical School, University of São Paulo (FMRP-USP).
Initially, patients aged 50 years or older with cancer in palliative care will be evaluated to assess the prevalence of myofascial pain syndrome using Travel and Simons' diagnostic criteria and for the following variables: demographic characteristics, functional status (Palliative Performance Scale), pain intensity (visual analog scale and pain threshold measurement with a pressure gauge), prognostic score (Palliative Prognosis Score), depression and anxiety (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 PAL) and analgesic drugs in use.
The participants that (1) accomplish the Travel and Simons' diagnostic criteria for myofascial pain syndrome, (2) have performance status on the Karnofsky scale of 30 or more, and (3) have pain intensity on visual analog scale of 5 or more will be randomized for the clinical trial.
The sample size calculation resulted in 15 participants for each group, totaling a sample composed of 30 patients.
The intervention group will be submitted to the trigger point injection procedure with 1% lidocaine, and the control group will receive usual care, defined as the treatment for pain prescribed by their assistant doctors.
Both groups will be reevaluated after 72 hours and 1 week after the procedure.
In the analysis statistics, chi-square test (or Fisher's exact test) will be used to evaluate categorical variables.
For the comparison between the groups at each moment (before and after intervention) will be used the linear mixed effects model.
The significance level established was <0.05.
SAS Statistical Software (version 9.3; SAS Institute, Inc. Cary , NC) will be used for the analysis.
Study Type
Interventional
Enrollment (Actual)
30
Phase
- Phase 3
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
-
-
SP
-
Ribeirão Preto, SP, Brazil, 14048900
- Laís Araujo Dos Santos Vilar
-
-
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
50 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
Participants that
- accomplish the Travel and Simons' diagnostic criteria for myofascial pain syndrome,
- have pain intensity on visual analog scale of 5 or more,
- have performance status on the Karnofsky Performance Status scale of 30 or more.
Exclusion Criteria:
- Use of high dose anticoagulants (RNI above the therapeutic range);
- Patients with hemorrhagic diathesis;
- Patients with moderate to severe dementia syndrome;
- Patients with diagnosis of acute confusional state during the follow-up;
- Occurrence of clinical complication or intervention that could compromise the reevaluation of pain in the following days (for example, undergoing a surgical procedure or nerve block) or death.
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: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1% lidocaine injection
The intervention group will be submitted to the trigger point injection procedure with 1% lidocaine (the sum of all needled trigger points will have a maximum of 10 ml), in a single intervention
|
The trigger point injection procedure with 1% lidocaine will be e (the sum of all needled trigger points will have a maximum of 10 ml), in a single intervention
|
No Intervention: Control Group
The control group will receive usual care, defined as the treatment for pain prescribed by their assistant doctors.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in pain intensity
Time Frame: 72 hours and 7 days
|
Assessed by Visual Analogic Scale (0 to 10).
This evaluation will be collected at baseline, after 72 hours and after 7 days in follow-up.
|
72 hours and 7 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in pain threshold measurement
Time Frame: 72 hours and 7 days
|
Assessed with a pressure gauge (Kg).
This evaluation will be collected at baseline, after 72 hours and after 7 days in follow-up.
|
72 hours and 7 days
|
Change in number of analgesic drugs in use
Time Frame: 72 hours and 7 days
|
Evaluation of the number of drugs in use, if there was an increase, reduction or maintenance of the number and doses of analgesic drugs comparing to the baseline.
|
72 hours and 7 days
|
Assessment of depression and anxiety simptoms
Time Frame: 7 days
|
Assessed by Hospital Anxiety and Depression Scale- scores ranged from 0 to 21 for anxiety and 0 to 21 for depression.
Higher scores mean worse outcome.
|
7 days
|
Assessment of quality of life
Time Frame: 7 days
|
Assessed by European Organization for Research and Treatment of Cancer Quality of Life Questionnarie Core 15 PAL
|
7 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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.
Helpful Links
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)
August 17, 2020
Primary Completion (Actual)
March 19, 2021
Study Completion (Actual)
May 17, 2022
Study Registration Dates
First Submitted
January 8, 2021
First Submitted That Met QC Criteria
January 8, 2021
First Posted (Actual)
January 11, 2021
Study Record Updates
Last Update Posted (Actual)
April 25, 2023
Last Update Submitted That Met QC Criteria
April 22, 2023
Last Verified
April 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Pathologic Processes
- Nervous System Diseases
- Disease
- Musculoskeletal Diseases
- Rheumatic Diseases
- Muscular Diseases
- Neuromuscular Diseases
- Syndrome
- Fibromyalgia
- Somatoform Disorders
- Myofascial Pain Syndromes
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Arrhythmia Agents
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Sensory System Agents
- Anesthetics
- Membrane Transport Modulators
- Anesthetics, Local
- Voltage-Gated Sodium Channel Blockers
- Sodium Channel Blockers
- Lidocaine
Other Study ID Numbers
- MPS_palliativecancer
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
IPD to be made available after the end of the study protocol
IPD Sharing Time Frame
After the publication of results of study
IPD Sharing Access Criteria
Researchers after the review and approval of protocol by the principal investigator
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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