MMA Infusion of Lidocaine for Treatment of Headache in Patients With Aneurysmal SAH (MIL-SAH)
Middle Meningeal Artery Infusion of Lidocaine for Treatment of Headache in Patients With Aneurysmal Subarachnoid Hemorrhage
調査の概要
詳細な説明
The MIL-SAH trial is a multicenter, randomized, double-blind, placebo-controlled clinical trial evaluating whether middle meningeal artery (MMA) infusion of lidocaine reduces headache severity in patients with aneurysmal subarachnoid hemorrhage (SAH). Adult patients with SAH undergoing endovascular aneurysm treatment are randomized to receive either bilateral MMA lidocaine infusion or placebo immediately after successful aneurysm securement.
SAH-related headaches are frequently severe, persistent, and difficult to control with current analgesic strategies, which often rely on opioids. Preliminary case series have suggested that MMA lidocaine infusion may reduce headache severity with few adverse effects, but randomized clinical trials to support this is currently lacking. This trial aims to provide robust data on the efficacy and safety of this novel treatment approach.
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究連絡先
- 名前:Rasmus H Dahl
- 電話番号:0045 35456491
- メール:rasmus.holmboe.dahl@regionh.dk
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion criteria
- Age ≥ 18 years
- Imaging showing a SAH and intracranial aneurysm
- Undergo endovascular therapy within 72 hours*
- Glasgow coma scale (GCS) score of 14-15
Maximum headache severity of NRS score ≥ 4 at a time > 1 hour after ictus or the ad-ministration of opioids due to headache
Exclusion criteria
- The patient is unable to understand information provided in the national language or English
- Known allergies to amide-type local anesthetics or iodinated contrast media
- Pregnancy or lactation
- Severe hepatic impairment
- History of epilepsy
- History of chronic opioid use
- Renal impairment with eGFR < 30 mL/min/1.73m2
- Current treatment with class III antiarrhythmics (e.g. amiodarone)
- Atrioventricular block of II and III degree
- Unsuccessful endovascular aneurysm securement or procedural complications
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:処理
- 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 |
|---|---|
|
実験的:MMA lidocaine
The participants will receive 50 mg of lidocaine in each middle meningeal artery
|
Participants will receive lidocaine hydrochloride at a dose of 50 mg per side (10 mg/mL; 5 mL).
The infusion is delivered into each MMA over 5 minutes by manual injection, resulting in a total injection time of approximately 10 minutes and a total lidocaine hydrochloride dose of 100 mg.
The trial intervention is performed only during the endovascular treatment session.
There is no repeated dosing of trial medication.
|
|
プラセボコンパレーター:MMA isotonic saline
The participants will receive isotonic saline in each middle meningeal artery
|
Participants will receive 5 mL of isotonic saline per side.
The infusion is delivered into each MMA over 5 minutes by manual injection, resulting in a total injection time of approximately 10 minutes.
The trial intervention is performed only during the endovascular treatment session.
There is no repeated dosing of trial medication.
|
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 |
|---|---|---|
|
Headache Severity
時間枠:From 0 to 72 hours postprocedure
|
Daily maximum headache severity over the first 72 hours following the trial intervention
|
From 0 to 72 hours postprocedure
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Headache relief
時間枠:From baseline to 2 hours postprocedure
|
Proportion of participants with headache relief (none to mild headache, NRS≤3) at 2 hours following the trial intervention
|
From baseline to 2 hours postprocedure
|
|
Opioid consumption
時間枠:From 0-72 hours postprocedure
|
Total opioid consumption (oral morphine equivalents) during the first 72 hours following the trial intervention
|
From 0-72 hours postprocedure
|
|
Patient global assessment
時間枠:From 0 to 72 hours postprocedure
|
Patient global assessment (PGA) score at 72 hours following the trial intervention.
Participants will be asked to respond to the question, "Overall, how do you feel about your level of headache control since the treatment?"
using a 5-point scale (poor, fair, good, very good, or excellent).
|
From 0 to 72 hours postprocedure
|
|
Adverse Events Related to Intraarterial Lidocaine Injection
時間枠:From 0 to 24 hours postprocedure
|
Proportion of participants with new onset of facial paresis, facial numbness, diplopia, blurry vision, or dizziness during the first 24 hours following the trial intervention
|
From 0 to 24 hours postprocedure
|
協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
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
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- p-2026-22097
- E-24086-04 (その他の助成金/資金番号:Copenhagen University Hospital - Rigshospitalet)
- Pilot Research Grant (その他の助成金/資金番号:European Society of Minimally Invasive Neurological Therapy)
- 2026-526092-36-00 (Ctis)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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