Dexmedetomidine Addition to Morphine in Patients With Metastatic Cancer
Does the Addition of Dexmedetomidine to Morphine Improve the Treatment of Pain in Patients With Metastatic Cancer? A Pilot Study
Pain is a common symptom in patients nearing the end of life. Its prevalence varies between 30 and 75%. Nowadays, morphine is the most used molecule as first line treatment of moderate to severe pain. However, this molecule, considering its side effects, may contribute in part to the discomfort of these patients and may increase the pre-existing agitation or delirium. There is therefore a need to find new agents, other than morphine, for pain control at the end of life, without the limitations that the morphine molecule has. The author reviewed the literature on the role of dexmedetomidine in the treatment of refractory symptoms in palliative care, including pain. It is an agonist of the adrenergic alpha 2 receptor having a sedative, analgesic action and a morphine sparing effect demonstrated postoperatively.
This study aims primarily at demonstrating that dexmedetomidine has a beneficial role in the treatment of pain in patients with metastatic cancer.
調査の概要
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Any painful patient with metastatic cancer
- Whatever type of pain: nociceptive, neuropathic, or mixed
- Age > 18 and <75 years
- Patient under analgesic Tier III treatment: with moderate to severe pain and not relieved by non-opioid conventional treatment
- Patient cooperating capable of responding to the pain assessment by providing a number from 0 to 10 at the VAS
- Patient providing his explicit consent to participate in the study before inclusion (regardless of his inclusion in C or D Group)
- Patients with systolic blood pressure (SBP) ≥ 100 mmHg and a diastolic blood pressure (DBP) ≥ 50 mmHg
- Patients with a heart rate ≥ 50/min
Exclusion Criteria:
- Patient refusal to participate in the study or patient unable to give consent
- Age <18 or > 75 years
- Comatose uncooperative patient unable to respond to the assessment of pain by VAS
- Hypotensive patients with SBP < 100 mmHg and DBP < 60 mmHg or bradycardic with a heart rate < 50/min
- Patient with a heart rhythm disorder, or a disorder of the atrial-ventricular conduction
- Patients under beta-blocker
- Patient with heart failure with an ejection fraction < 40%
- Patient suffering from allergy or previous intolerance to morphine or dexmedetomidine
- Patient with renal impairment with a creatinine clearance <3 0ml/min/1.73m2, or patient under hemodialysis or peritoneal dialysis.
- Patient with severe hepatic impairment with Child-Pugh score at C.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：4倍
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
介入なし：コントロール
|
|
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実験的：デクスメデトミジン
|
Patients allocated to this group receive a combination of Morphine and Dexmedetomidine
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Pain score
時間枠：48 hours
|
The visual analogue score is used to asses for pain score, the scale varies between 0 and 10 where 0 is no pain and 10 is worst pain encountered
|
48 hours
|
|
モルヒネの消費
時間枠：48時間
|
48時間
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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