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.
研究概览
研究类型
注册 (实际的)
阶段
- 阶段2
- 第三阶段
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:卫生服务研究
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:四人间
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
无干预:控制
|
|
实验性的:右美托咪定
|
Patients allocated to this group receive a combination of Morphine and Dexmedetomidine
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Pain score
大体时间: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
|
吗啡消耗量
大体时间:48小时
|
48小时
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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