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Low Dose Methoxyflurane for Pain Relief During Minor Out-patient Urologic Procedures

Phase 4
Conditions
Pain, Acute
Interventions
Drug: Methoxyflurane, MEOF
Registration Number
NCT04412642
Lead Sponsor
Sunnybrook Health Sciences Centre
Brief Summary

The participant will be trained to self administer the drug and will be supplied with a PENTHROX commercial inhaler kit .The study nurse will train the participant and supervise its use during the procedure.Immediately following the procedure the participant will be asked to fill out two brief questionnaires. The study nurse will assess the participant for adverse event and will follow-up with a phone call 24 hours later.

Detailed Description

Many patients with chronic urological conditions require multiple and sometimes painful urological procedures. Ideally these procedures may be done in the cystoscopy suite without a general anesthetic. Low dose methoxyflurane, (MEOF)is a inhaled, self-administered non-opioid analgesic and has been approved by Health Canada's for the short-term relief of moderate to severe acute pain, associated with trauma or international medical procedures, in conscious adult patients. The brand name is PENTHROX.

This study is a single centre, pilot study to assess the feasibility of using a self-administrated, MEOF for pain relief during minor out-patient urological procedures. Eligible participants will receive a one time dose of the the study medication during a planned, outpatient urological procedure done under cystoscopy in the Cystoscopy clinic

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
10
Inclusion Criteria
  1. Conscious adult patients >=

  2. Patient is scheduled for cystoscopy And:

    • BOTOX injections for Overactive Bladder /Neuogenic Detrusor Overactivity,
    • Diagnostic hydrodistention for painful bladder syndrome
    • Biopsy or cauterization of bladder tumors
    • Biopsy, cauterization and/or injection of Hunner's lesions
    • Visual urethrotomy/bladder neck incision=/- injection of stricture
    • Evaluation of the complex urinary tract problems
  3. Patient (patient/or patient's authorization legal representative) should understand the nature of the study and provide written informed consent

  4. Patient is able to follow all study requirements and procedures and complete required questionnaires

Exclusion Criteria
  1. An altered level of consciousness, due to any cause, including head injury, drugs,or alcohol
  2. Clinically significant renal impairment
  3. Women of child bearing potential who are pregnant or peri partum, including labour
  4. A history of liver dysfunction after previous MEOF use or other halogenated anesthetics
  5. Hypersensitivity to MEOF or other halogenated anesthetics, or to butylated hydroxytoluene
  6. Known or genetically susceptible to malignant hyperthermia or a history of severe adverse reactions in either patient or relatives
  7. Exacerbation of an underlying condition (i.e., chronic pain)
  8. Clinically evident or potential hemodynamic instability as per the opinion of the investigator
  9. Clinically evident respiratory impairment as per the opinion of the investigator
  10. Prior treatment with PENTHROX within 3 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
methoxyfluraneMethoxyflurane, MEOFmethoxyflurane
Primary Outcome Measures
NameTimeMethod
Patient satisfaction measured using the Patient Global assessment of Medication Performance (GMP)at the time of dischargeend of procedure

Global assessment of Medication,which is an assessment, performed by the patient, of the patient's impression of how well the medication works. The patient is asked to rate the pain relief given by methoxyflurane using a 5-point likert scale - 0=poor;1=fair;2=good;3=very good;4=excellent

Secondary Outcome Measures
NameTimeMethod
Percent patients requiring rescue medicationduring the procedure

Documentation of the use of rescue medication post administration of methooxyflurane Documenting first time of use of rescue medication, type of medication administered,dose and route

The Overall/Maximum pain intensity experienced at any point during the procedure using a numeric rating scaleduring the procedure

Patient is asked to rate the intensity of the pain experienced using an 11-point numeric rating scale is used. A score of 0=no pain and a score of 10= worst pain possible

Safety outcome measure to assess percentage of patients requiring rescue medicationDuring the procedure;post procedure and at 24 hours post procedure (phone contact)

Documentation of adverse events as safety outcome measure by the health care professional

Assessment of how well the medication fulfilled the health care professional's expectations of pain relief using the Fulfillment of of Pain Relief Expectation Scaleend of procedure

The health care professional is asked a single question "To what extent has your expectations regarding pain control been met?", using the Fulfillment of Pain Relief Expectation scale, which uses a 5-point Likert scale - 0=poor;1=fair;2=good;3=very good;4=excellent

Health professional impression of how well the medication worked measured using the Patient Global assessment of Medication Performance (GMP)at the time of dischargeend of procedure

Global assessment of Medication Performance, is an assessment, performed by the health care professional, of their impression of how well the medication works. The health care professional is asked a single question "rate the pain relief provided by methoxyflurane using a 5-point likert scale - 0=poor;1=fair;2=good;3=very good;4=excellent

Assessment of how well the medication fulfilled the patient's expectations of pain relief using the Fulfillment of of Pain Relief Expectation Scaleend of procedure

The patient is asked a single question "To what extent has your expectations regarding pain control been met?", using the Fulfillment of Pain Relief Expectation scale, which uses a 5-point Likert scale - 0=poor;1=fair;2=good;3=very good;4=excellent

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