Pilot Randomized Control Trial Comparing Oral Ketamine and Oral Oxycodone for Pain Control in Emergency Department Patients (PKORCT)
The goal of this pilot randomized clinical trial is to learn if oral ketamine intervention can control pain in emergency department patients whose providers feel the need for additional pain medication. The main questions it aims to answer are:
- Does oral ketamine result in a different mean change in pain scores compared with oral oxycodone?
- Is there a difference in the need for additional opioid administration within 24 hours after the initial dose of study medication (oral ketamine vs oral oxycodone)?
Researchers will compare oral ketamine to oral oxycodone to see if there is a difference in pain control or the need for additional opioid administration.
Participants will:
- Fill out a survey prior to study medication administration assessing pain scores, pain presentation, and medication history
- Be randomized to and receive a dose of oral ketamine or oral oxycodone as the study medication for pain control
- Fill out a survey assessing pain control, side effects, and safety outcomes
- Receive follow-up phone calls at 1 and 3 months after enrollment to assess pain and opioid use
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
In an effort to combat the ongoing opioid crisis, healthcare providers continue to search for alternatives to opioids that are both safe and effective. While no medicine has an ideal profile, oral ketamine have attributes that may serve emergency department (ED) patients well when dealing with painful conditions. While IV ketamine has been well-studied in the ED setting and oral ketamine has been studied in the post-operative setting, there is limited data describing the safety and effectiveness of oral ketamine in the ED setting. Guided by colleagues from the Anesthesia Acute Pain Service, the Albany Medical Center (AMC) ED has begun giving oral ketamine to appropriate ED patients with painful conditions. We aim to conduct a pilot, un-blinded randomized controlled trial to compare the benefits and detriments of oral ketamine vs. oxycodone in ED patients who require 'second line' pain medicine.
A convenience sample of emergency department patients will be randomized to receive either:
Oxycodone arm:
o The treating provider will order oral oxycodone 5 mg times one
or
o The treating provider has made a deliberate decision that the patient requires (because of weight, prior exposures, etc.) greater than oxycodone 5mg times one
Oral ketamine arm:
o The treating provider will order ketamine 0.75 mg/kg oral times one (max 80mg)
Outcomes measured
Participants will be assessed for
- Pain scores at 30 and 60 minutes after either study drug administration
- Whether they received opioids at 6 hours, 12 hours, and 24 hours after receiving either study drug
- For admitted patients, whether they received opioids upon admission to the hospital, and whether they were discharged with a prescription for opioids
- Whether the participation has received opioid pain medicines, ketamine, or other recreational drugs during the one month after enrolling in the study
- Whether the participation has received opioid pain medicines, ketamine, or other recreational drugs during the three months after enrolling in the study
We will calculate a difference in change in mean pain scores before and after the intervention in each study arm. We will also compare morphine milli-equivalents use during the time intervals above, as well as usage of opioids, ketamine, and recreational drugs during the one month and three month period after enrollment.
Because this is a pilot study, we have not calculated an effect size.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
- Fase 3
Contatti e Sedi
Luoghi di studio
-
-
New York
-
Albany, New York, Stati Uniti, 12208
- Albany Medical Center Emergency Department
-
Contatto:
- Michael Waxman, MD
- Numero di telefono: 518-262-3443
- Email: waxmanm@amc.edu
-
Contatto:
- Andrew Chang, MD, MS
- Numero di telefono: 518-262-3443
- Email: changa1@amc.edu
-
Investigatore principale:
- Michael Waxman, MD
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- ED patient aged 18 years or older AND
- English proficient AND
- Able to give informed consent AND
- Has a painful condition in the ED that includes any of the following: Musculoskeletal extremity pain, Musculoskeletal back or neck pain, Other nociceptive extremity pain
- AND treating provider has deemed the patient necessitating 'second line pain therapy' (meaning: opioids or ketamine)
Exclusion Criteria:
Any of the following:
- Prisoner status
- Pregnant
- Non-English proficient
- Cannot give informed consent
- Requires emergent intravenous pain medicine (as deemed by the treating provider)
- Prior participation in the study
- Previous diagnosis of opioid use disorder
- Previous ketamine addiction
- Patient is in hospice or other palliative care measures
- Contraindication to ketamine, including: Cystitis or bladder pain, Intracranial hypertension, Known coronary artery disease, Age greater than 75 years old, History of prior adverse reaction to ketamine or oxycodone, History or current major psychiatric disorder (as deemed by the treating ED clinician) or history of psychosis
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: oral ketamine
The oral ketamine arm will receive a dose of oral ketamine as a second line pain medication.
|
A dose of oral ketamine administered as a second line pain management medicine in the emergency department.
|
|
Comparatore attivo: oxycodone
The oxycodone arm will receive a dose of oxycodone as a second line pain medication.
|
A dose of oxycodone administered as a second line pain management medicine in the emergency department.
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Change in mean pain score
Lasso di tempo: This will be assessed at 30 minutes and 60 minutes after receiving the study drugs.
|
This reflects the mean difference between the pain scores before and after the intervention.
|
This will be assessed at 30 minutes and 60 minutes after receiving the study drugs.
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Usage of morphine in the following 24 hours.
Lasso di tempo: 24 hours
|
Usage of morphine in the following 24 hours.
|
24 hours
|
|
Usage of opioids, ketamine, or recreational drugs one month and three months after study enrollment.
Lasso di tempo: 1 month and 3 months after study enrollment.
|
Usage of opioids, ketamine, or recreational drugs one month and three months after study enrollment.
|
1 month and 3 months after study enrollment.
|
Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Manifestazioni neurologiche
- Malattie del sistema nervoso
- Manifestazioni neurocomportamentali
- Disturbi percettivi
- Condizioni patologiche, segni e sintomi
- Segni e sintomi
- Agnosi
- Prodotti chimici organici
- Composti eterociclici
- Composti eterociclici, anello fuso
- Idrocarburi
- Ciclohexanes
- Cicloparaffins
- Idrocarburi, aliciclici
- Idrocarburi, ciclici
- Alcaloidi
- Idrocarburi policiclici aromatici
- Composti policiclici
- Composti eterociclici, 4 o più anelli
- Morfinani
- Alcaloidi oppiati
- Composti eterociclici, anello a ponte
- Fenantreni
- Derivati della morfina
- Codeina
- Ketamina
- Ossicodone
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 7471
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