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Efficacy of Sublingual Midazolam in Association With Oral Morphine in Children Analgesia After Bone Fracture

Phase 3
Completed
Conditions
Fractures
Interventions
Drug: Midazolam
Drug: Placebo
Registration Number
NCT00416039
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

It is a randomized simple-blind monocentric study; the group A will receive oral morphine with placebo and the group B will receive oral morphine with sublingual midazolam. The aim of this study is to show a more important pain decrease in the group taking midazolam versus placebo.

Detailed Description

Fracture is often responsible of pain in the paediatric emergency department (ED). This pain is very severe and needs effective drugs.

During a study made at the ED of Necker Enfants Malades Hospital, it has been shown that the oral morphine had a limited action on this kind of pain. Therefore it is interesting to increase the analgesia by making a drug association, for example with the midazolam witch is a benzodiazepine with a sedative and anxiolytic action, and which has got the MMA for the intravenous and the intra rectal forms for children older than 6 months.

The intravenous form has some disadvantages like an extra work and an increase of risk of side effects.

That is why the sublingual form seems to be interesting in this context. Even if some studies have shown the benefit of midazolam as a preanesthetic medication given to children scheduled for a surgical procedure, none has shown the interest of sublingual midazolam associated with oral morphine to relieve the pain due to a displaced fracture.

The aim of this study is to show a more important pain decrease in the group taking midazolam versus placebo.

It is a randomized simple-blind monocentric study; the group A will receive oral morphine with placebo and the group B will receive oral morphine with sublingual midazolam . The pain will be quantified thanks to the visual analogical scale (VAS)before and 30 minutes after the drugs administration, and we will try to show a difference of 15 points(on 100) of the VAS at 30 minutes between the two groups.

60 patients aged from 5 to 16 years old and having a displaced fracture will be enrolled in this study which will last 1 year.

Patients having a contra-indication for morphine and midazolam won't be enrolled as patients with femoral fracture which needs a local anaesthesia.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • children between 5 and 16 years old
  • children with a disjoined bone fracture
  • children needed oral morphine analgesia
  • written informed consent from one or the two parents or legal pad
Read More
Exclusion Criteria
  • ASA score > 2
  • concomitant administration of oral analgesia (level II WHO classification) less than 6 hours
  • concomitant administration of benzodiazepine less than 24 hours
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1MidazolamMidazolam and morphine
2Placeboplacebo, Nacl 0.9 %, morphine 0.5 mg/kg
Primary Outcome Measures
NameTimeMethod
Difference in the measurement of pain analogical scale values at 30 minutes between the two groupsafter administration until 120 minutes
Secondary Outcome Measures
NameTimeMethod
Pain Analogical scale Values at 15, 30 minutes, 1 hour, 1h30 and 2 hours.after administration until 120 minutes
Pain Analogical scale Values after the treatment of the fractureafter administration until 120 minutes
Respiratory rate, Oxymetryafter administration until 120 minutes
Conscience (lethargy or irritability)after administration until 120 minutes
nausea,after administration until 120 minutes
skin hyperesthesia, rashafter administration until 120 minutes
children cooperationafter surgical procedure

Trial Locations

Locations (1)

Hopital Necker enfants Malade - Department of Pediatric Emergency

🇫🇷

Paris, France

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