Analgesic Effect of Paracetamol in Patients With Femur Fracture: is Intravenous Better Than Oral?
8 oktober 2021 uppdaterad av: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
The purpose of this study is to monitor severe pain for femur fracture after treatment with paracetamol IV or OR.
Studieöversikt
Detaljerad beskrivning
The investigators enrolled 170 consecutive patients with femur fracture and severe pain.
The patients received an initial analgesic treatment with paracetamol orally (OR) or intravenously (IV).
The primary outcome was the reduction of pain of 1 point at visual analogue scale for pain (VAS) after the 1 st hour of treatment (T1).
Secondary endpoints included the reduction of pain of at least 2 points on the VAS scale at the 4 th hour (T4), the need of rescue therapy and the number of adverse events.
Studietyp
Observationell
Inskrivning (Faktisk)
170
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
-
-
-
Roma, Italien, 00168
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS
-
-
Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
18 år och äldre (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Testmetod
Sannolikhetsprov
Studera befolkning
Patients with femur fracture admitted to the ED of Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
Beskrivning
Inclusion Criteria:
- Age ≥ 18 years
- Patients admitted to the ED of Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome
- Femur Fracture
- Patients who signed the informed consent
- Able to take analgesic therapy both orally (OR) and intravenously (IV)
- Able to define pain by VAS
Exclusion Criteria:
- Age <18 years
- Allergy to paracetamol
- Unable to take analgesic therapy both orally (OR) and intravenously (IV)
- Unable to define pain by VAS
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
Intervention / Behandling |
|---|---|
|
Paracetamol IV
Patients with femur fracture that received an initial analgesic treatment with paracetamol intravenously (IV).
|
Paracetamol given orally or intravenously
Andra namn:
|
|
Paracetamol OR
Patients with femur fracture that received an initial analgesic treatment with paracetamol orally (OR).
|
Paracetamol given orally or intravenously
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Pain change of 1 point at visual analogue scale for pain (VAS) after the 1 st hour of treatment (T1).
Tidsram: Baseline and 1 hour
|
The Visual Analogue Scale for Pain (VAS) is a validated self-reported instrument that identifies pain from 0 to 10 (with 0 = no pain and 10 = maximum pain intensity)
|
Baseline and 1 hour
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Pain change of at least 2 points on the VAS scale at the 4 th hour (T4)
Tidsram: Baseline and 4 hours
|
identifies pain from 0 to 10 (with 0 = no pain and 10 = maximum pain intensity)
|
Baseline and 4 hours
|
Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Utredare
- Studierektor: Francesco Franceschi, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Publikationer och användbara länkar
Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.
Allmänna publikationer
- Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. doi: 10.1002/acr.20543. No abstract available.
- Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C; IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012 Sep;23(9):2239-56. doi: 10.1007/s00198-012-1964-3. Epub 2012 Mar 15.
- Roder F, Schwab M, Aleker T, Morike K, Thon KP, Klotz U. Proximal femur fracture in older patients--rehabilitation and clinical outcome. Age Ageing. 2003 Jan;32(1):74-80. doi: 10.1093/ageing/32.1.74.
- Larsen P, Ceccotti AA, Elsoe R. High mortality following distal femur fractures: a cohort study including three hundred and two distal femur fractures. Int Orthop. 2020 Jan;44(1):173-177. doi: 10.1007/s00264-019-04343-9. Epub 2019 May 12.
- Uysal AI, Altiparmak B, Yasar E, Turan M, Canbek U, Yilmaz N, Gumus Demirbilek S. The effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial. Ulus Travma Acil Cerrahi Derg. 2020 Jan;26(1):109-114. doi: 10.14744/tjtes.2019.78002.
- Dizdarevic A, Farah F, Ding J, Shah S, Bryan A, Kahn M, Kaye AD, Gritsenko K. A Comprehensive Review of Analgesia and Pain Modalities in Hip Fracture Pathogenesis. Curr Pain Headache Rep. 2019 Aug 6;23(10):72. doi: 10.1007/s11916-019-0814-9.
- Gangavalli AK, Nwachuku CO. Management of Distal Femur Fractures in Adults: An Overview of Options. Orthop Clin North Am. 2016 Jan;47(1):85-96. doi: 10.1016/j.ocl.2015.08.011.
- Glinkowski W, Narloch J, Krasuski K, Sliwczynski A. The Increase of Osteoporotic Hip Fractures and Associated One-Year Mortality in Poland: 2008-2015. J Clin Med. 2019 Sep 18;8(9):1487. doi: 10.3390/jcm8091487.
- Soffin EM, Gibbons MM, Wick EC, Kates SL, Cannesson M, Scott MJ, Grant MC, Ko SS, Wu CL. Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Hip Fracture Surgery. Anesth Analg. 2019 Jun;128(6):1107-1117. doi: 10.1213/ANE.0000000000003925.
- Fabi DW. Multimodal Analgesia in the Hip Fracture Patient. J Orthop Trauma. 2016 May;30 Suppl 1:S6-S11. doi: 10.1097/BOT.0000000000000561.
- Elsoe R, Ceccotti AA, Larsen P. Population-based epidemiology and incidence of distal femur fractures. Int Orthop. 2018 Jan;42(1):191-196. doi: 10.1007/s00264-017-3665-1. Epub 2017 Nov 7.
- Bonnin MP, Neto CC, Aitsiselmi T, Murphy CG, Bossard N, Roche S. Increased incidence of femoral fractures in small femurs and women undergoing uncemented total hip arthroplasty - why? Bone Joint J. 2015 Jun;97-B(6):741-8. doi: 10.1302/0301-620X.97B6.35022.
- Lim SJ, Yeo I, Yoon PW, Yoo JJ, Rhyu KH, Han SB, Lee WS, Song JH, Min BW, Park YS. Incidence, risk factors, and fracture healing of atypical femoral fractures: a multicenter case-control study. Osteoporos Int. 2018 Nov;29(11):2427-2435. doi: 10.1007/s00198-018-4640-4. Epub 2018 Jul 23.
- Mattisson L, Bojan A, Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Musculoskelet Disord. 2018 Oct 12;19(1):369. doi: 10.1186/s12891-018-2276-3.
- Rowlands M, Walt GV, Bradley J, Mannings A, Armstrong S, Bedforth N, Moppett IK, Sahota O. Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomised controlled trial. BMJ Open. 2018 Apr 10;8(4):e019650. doi: 10.1136/bmjopen-2017-019650.
- Oc Y, Varol A, Yazar EA, Ak S, Akpolat AO, Kilinc BE. Treatment strategy for elderly patients with the isolated greater trochanteric fracture. SAGE Open Med. 2020 Oct 7;8:2050312120964138. doi: 10.1177/2050312120964138. eCollection 2020.
- Li L, Bennett-Brown K, Morgan C, Dattani R. Hip fractures. Br J Hosp Med (Lond). 2020 Aug 2;81(8):1-10. doi: 10.12968/hmed.2020.0215.
- Makkar JK, Jain K, Kuberan A, Balasubramanian M, Bhatia N, Singh PM. Pre-emptive multimodal analgesic regimen reduces post-operative epidural demand boluses in traumatic shaft of femur fracture - A randomised controlled trial. Indian J Anaesth. 2019 Nov;63(11):895-899. doi: 10.4103/ija.IJA_363_19. Epub 2019 Nov 8.
- Chuang PY, Shen SH, Yang TY, Huang TW, Huang KC. Non-steroidal anti-inflammatory drugs and the risk of a second hip fracture: a propensity-score matching study. BMC Musculoskelet Disord. 2016 May 4;17:201. doi: 10.1186/s12891-016-1047-2.
- Franceschi F, Marsiliani D, Alesi A, Mancini MG, Ojetti V, Candelli M, Gabrielli M, D'Aurizio G, Gilardi E, Adducci E, Proietti R, Buccelletti F. A simplified way for the urgent treatment of somatic pain in patients admitted to the emergency room: the SUPER algorithm. Intern Emerg Med. 2015 Dec;10(8):985-92. doi: 10.1007/s11739-015-1304-7. Epub 2015 Sep 4.
- Di Filippo A, Magherini M, Ruggiano P, Ciardullo A, Falsini S. Postoperative analgesia in patients older than 75 years undergoing intervention for per-trochanteric hip fracture: a single centre retrospective cohort study. Aging Clin Exp Res. 2015 Jun;27(3):281-5. doi: 10.1007/s40520-014-0272-5. Epub 2014 Sep 17.
- Aprato A, Bechis M, Buzzone M, Bistolfi A, Daghino W, Masse A. No rest for elderly femur fracture patients: early surgery and early ambulation decrease mortality. J Orthop Traumatol. 2020 Aug 30;21(1):12. doi: 10.1186/s10195-020-00550-y.
- Mubark I, Abouelela A, Genena A, Al Ghunimat A, Sarhan I, Ashwood N. Mortality Following Distal Femur Fractures Versus Proximal Femur Fractures in Elderly Population: The Impact of Best Practice Tariff. Cureus. 2020 Sep 30;12(9):e10744. doi: 10.7759/cureus.10744.
- Piscitelli P, Neglia C, Feola M, Rizzo E, Argentiero A, Ascolese M, Rivezzi M, Rao C, Miani A, Distante A, Esposito S, Iolascon G, Tarantino U. Updated incidence and costs of hip fractures in elderly Italian population. Aging Clin Exp Res. 2020 Dec;32(12):2587-2593. doi: 10.1007/s40520-020-01497-0. Epub 2020 Feb 13.
- Guzon-Illescas O, Perez Fernandez E, Crespi Villarias N, Quiros Donate FJ, Pena M, Alonso-Blas C, Garcia-Vadillo A, Mazzucchelli R. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res. 2019 Jul 4;14(1):203. doi: 10.1186/s13018-019-1226-6.
- Peeters CM, Visser E, Van de Ree CL, Gosens T, Den Oudsten BL, De Vries J. Quality of life after hip fracture in the elderly: A systematic literature review. Injury. 2016 Jul;47(7):1369-82. doi: 10.1016/j.injury.2016.04.018. Epub 2016 Apr 23.
- Mian P, Allegaert K, Spriet I, Tibboel D, Petrovic M. Paracetamol in Older People: Towards Evidence-Based Dosing? Drugs Aging. 2018 Jul;35(7):603-624. doi: 10.1007/s40266-018-0559-x.
- Gazelka HM, Leal JC, Lapid MI, Rummans TA. Opioids in Older Adults: Indications, Prescribing, Complications, and Alternative Therapies for Primary Care. Mayo Clin Proc. 2020 Apr;95(4):793-800. doi: 10.1016/j.mayocp.2020.02.002.
- Gemmati D, Varani K, Bramanti B, Piva R, Bonaccorsi G, Trentini A, Manfrinato MC, Tisato V, Care A, Bellini T. "Bridging the Gap" Everything that Could Have Been Avoided If We Had Applied Gender Medicine, Pharmacogenetics and Personalized Medicine in the Gender-Omics and Sex-Omics Era. Int J Mol Sci. 2019 Dec 31;21(1):296. doi: 10.3390/ijms21010296.
- Di Sanzo M, Cipolloni L, Borro M, La Russa R, Santurro A, Scopetti M, Simmaco M, Frati P. Clinical Applications of Personalized Medicine: A New Paradigm and Challenge. Curr Pharm Biotechnol. 2017;18(3):194-203. doi: 10.2174/1389201018666170224105600.
- Dixon J, Ashton F, Baker P, Charlton K, Bates C, Eardley W. Assessment and Early Management of Pain in Hip Fractures: The Impact of Paracetamol. Geriatr Orthop Surg Rehabil. 2018 Oct 25;9:2151459318806443. doi: 10.1177/2151459318806443. eCollection 2018.
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart (Faktisk)
1 juni 2019
Primärt slutförande (Faktisk)
30 juni 2020
Avslutad studie (Faktisk)
30 juni 2020
Studieregistreringsdatum
Först inskickad
24 augusti 2021
Först inskickad som uppfyllde QC-kriterierna
24 augusti 2021
Första postat (Faktisk)
27 augusti 2021
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
11 oktober 2021
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
8 oktober 2021
Senast verifierad
1 juni 2020
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- Prot. 36041/19 ID: 2727
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
JA
IPD-planbeskrivning
All IPD that underlie results of the publication
Tidsram för IPD-delning
The data will be available immediately and ending 3 years after the publication of the study.
Kriterier för IPD Sharing Access
Proposals should be directed to francesco.franceschi@policlinicogemelli.it.
To gain access, requestors will need to sign a data access agreement.
IPD-delning som stöder informationstyp
- STUDY_PROTOCOL
- SAV
- ICF
- ANALYTIC_CODE
- CSR
Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .