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
研究概览
详细说明
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.
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名:Rasmus H Dahl
- 电话号码:0045 35456491
- 邮箱:rasmus.holmboe.dahl@regionh.dk
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 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 |
|---|---|
|
实验性的: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.
|
|
安慰剂比较: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.
|
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 |
|---|---|---|
|
Headache Severity
大体时间: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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Headache relief
大体时间: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
大体时间: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
大体时间: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
大体时间: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
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
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
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- p-2026-22097
- E-24086-04 (其他赠款/资助编号:Copenhagen University Hospital - Rigshospitalet)
- Pilot Research Grant (其他赠款/资助编号:European Society of Minimally Invasive Neurological Therapy)
- 2026-526092-36-00 (克蒂斯)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
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