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Sodium Bicarbonate for Acute Peripheral Vertigo

Not Applicable
Recruiting
Conditions
Peripheral Vertigo
Interventions
Registration Number
NCT05676216
Lead Sponsor
National Taiwan University Hospital
Brief Summary

Vertigo is defined as the hallucination of spinning sensation or rotatory movement and is frequently combined with severe nausea and vomiting. In Taiwan, an average of 3.13 cases per 100 persons suffer from acute vertigo attack per year. And 1 in 3 patients with vertigo will have recurrent attack within a year. The sensation of disequilibrium and severe nausea and vomiting urge patients visit emergent department (ED) for help. Therefore, vertigo is one of the most common complaints in ED.

Vertigo can be divided into central type and peripheral type. Central type vertigo included life threatening disease like brainstem hemorrhage or infraction. Although peripheral vertigo is mostly benign, the acute symptoms relief are usually needed. The first line therapy of acute peripheral vertigo is using antihistamine or benzodiazepine with other anti-emetic agents. However, these agents usually have side effects of fatigue and lethargy, which will cause increasing patients' length of stay or elders' risk of falling.

Sodium bicarbonate is widely used in treating hyperkalemia or metabolic acidosis. Its safety and no side effect have also been proved. There were few reports of using sodium for treatment of acute vertigo in Taiwan and Japan. However, there is no strong evidence of comparing this therapy with other medication.

This study hypothesized that there is an equivalence of efficacy between sodium bicarbonate and diphenhydramine for treatment of vertigo. Using sodium can cause less fatigue or lethargy and can decrease ED length of stay. This study aims to perform a double-blinded randomized controlled trial to evaluate the efficacy of sodium bicarbonate for treatment of acute peripheral vertigo.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
225
Inclusion Criteria
  • Patients with acute onset vertigo
Exclusion Criteria
  • Pregnancy
  • First vertigo episode over 24 hours
  • Using any anti-vertigo medicine after onset
  • Drug allergy to Sodium bicarbonate or Diphenhydramine
  • Diagnosed with central vertigo
  • Heart failure NYHA class >1
  • Chronic kidney disease (CKD) stage ≥ 3

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Diphenhydramine with Sodium BicarbonateDiphenhydramine + Sodium BicarbonateDiphenhydramine 30 mg in 100 mL normal saline intravenous dripping with Sodium bicarbonate 66.4 mEq intravenous push
DiphenhydramineDiphenhydramineDiphenhydramine 30 mg in 100 mL normal saline intravenous dripping
Sodium BicarbonateSodium BicarbonateSodium bicarbonate 66.4 mEq in 100 mL normal saline intravenous dripping
Primary Outcome Measures
NameTimeMethod
Reduction in vertigo intensityBaseline and 60 minutes after drug administration

Reduction in Vertigo Visual Analog Scale (VAS 0\~10, higher scores mean higher intensity) from baseline

Secondary Outcome Measures
NameTimeMethod
Reduction in nausea intensityBaseline and 60 minutes after drug administration

Reduction in Nausea Visual Analog Scale (VAS 0\~10, higher scores mean higher intensity) from baseline

Lethargy60 minutes after drug administration

Lethargy score (score 1\~4, 1 indicates no lethargy and 4 indicates very lethargy)

Improvement of ambulatory abilityBaseline and 60 minutes after drug administration

Change in objective ambulatory ability (score 1\~4, higher scores mean a worse outcome) from baseline

Emergency Department staying timeup to 24 hours

From patients admit to Emergency Department until patients discharge (up to 24 hours)

Trial Locations

Locations (1)

National Taiwan University Yunlin Branch

🇨🇳

Yunlin County, Taiwan

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