NCT07274254招募中3 期
Lidocaine for Opioid Sparing in Vaso-occlusive Crisis of Sickle Cell Disease
干预措施
相关药物
试验速览
- 阶段
- 3 期
- 状态
- 招募中
- 入组人数
- 104
- 试验地点
- 32
- 主要终点
- Cumulative parenteral opioid dose between randomization and discharge from the intensive care unit expressed in morphine milligram equivalent.
研究概览
简要总结
The purpose of the study is to determine whether adding lidocaine to standard of care in pain management during severe vaso-occlusive crisis has an effect on the cumulative opioid consumption expressed as morphine milligram equivalent.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age >= 18 years
- •Known sickle cell disease with an SS, SC, Sβ, or Sβ+ genotype
- •Patient admitted to the Intensive Care Unit for Vaso-Occlusive Crisis and/or ACS as the main reason for admission:
- •Vaso-Occlusive Crisis defined by acute pain or tenderness, affecting at least one part of the body, including limbs, ribs, sternum, head (skull), spine, and/or pelvis, not attributable to other causes
- •Acute Chest Syndrome defined by the association of clinical respiratory sign(s): dyspnea and/or chest pain and/or auscultatory abnormality (crepitants and/or bronchial breathing) with a new pulmonary infiltrate on chest X-ray, thoracic CT-scan, or lung ultrasound.
- •Treatment with parenteral morphine or oxycodone started less than 72 hours prior to inclusion
- •Patient or next of kin informed about the study and having consented to the participation of the patient in the study. If patient is no competent and no next of kin can be contacted during screening for the study, trial inclusion will be completed as an emergency procedure by the Intensive Care Unit physician, in compliance with French law.
- •French speaking
- •Patient with health care insurance
排除标准
- •Pregnant women or nursing mothers; Women of child bearing potential will be tested for pregnancy before inclusion
- •Patients under guardianship, curatorship or under legal protection
- •Prisoners or subjects who are involuntarily incarcerated
- •Sickle Cell Disease acute complication other than Vaso-Occlusive Crisis or Acute Chest Syndrome as the main reason for admission:
- •priapism, stroke, acute splenic sequestration, acute hepatic sequestration, bone marrow necrosis…
- •Patients wearing a lidocaine-medicated plaster at the time of screening for inclusion
- •Known or assumed hypersensitivity to lidocaine hydrochloride, other local anaesthetics (e.g., bupivacaine or ropivacaine) or an excipient
- •Patients treated with anti-arhythmic drugs known to induce torsade de pointe.
- •Patients on chronic or occasional treatment with drugs that interact with the 3A cytochrome isoenzymes (CYP3A) and/or 1A2 cytochrome isoenzymes (CYP1A2)
- •Patients with recurrent porphyria, porphyria in remission, or known asymptomatic carriage of gene mutations responsible for porphyria
- •Epileptic patients
- •Hypovolemic shock or shock of other cause at screening for inclusion
- •Known atrioventricular block, QT prolongation or other heart conduction disorder or heart failure
- •Chronic respiratory failure with long term non invasive ventilation (excluding Continuous Positive Air way pressure), or long term oxygen therapy at home
- •Acute Respiratory Distress Syndrome according to The 2012 Berlin definition
- •Acute or Chronic liver failure with MELD > 19
- •Acute or Chronic kidney failure with clearance <30mL/min/m2 according to CKD-EPI
- •Body weight <40kg and >120kg
- •Prior inclusion in the study in the last 3 months
- •Patient under invasive mechanical ventilation
- •Altered consciousness with Glasgow coma scale <13
- •Patient already included in a clinical drug
研究组 & 干预措施
Control group: placebo + standard of care
Placebo Comparator
Placebo is 20 mL ampoules of sodium chloride (NaCl 0.9%) for injection. Administration : parenteral route on peripheral or central venous catheter.
- Bolus of 1.5 mg/kg bolus during 30 minutes, with a maxium dose of 180 mg (18mL)
- Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h = 12mL/h) during 72 hours.
干预措施: Standard of care (Drug)
Control group: placebo + standard of care
Placebo Comparator
Placebo is 20 mL ampoules of sodium chloride (NaCl 0.9%) for injection. Administration : parenteral route on peripheral or central venous catheter.
- Bolus of 1.5 mg/kg bolus during 30 minutes, with a maxium dose of 180 mg (18mL)
- Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h = 12mL/h) during 72 hours.
干预措施: Placebo (Drug)
Experimental group: Lidocaine + standard of care
Experimental
Lidocaine hydrochloride 20 mg/mL, solution, 20 mL ampoule for intravenous administration Administration : parenteral route on peripheral or central venous catheter.
- Bolus of 1.5 mg/kg bolus during 30 minutes, with a maximum dose of 180 mg (18mL)
- Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h =- 12mL/h) during 72 hours.
干预措施: Lidocain (Drug)
Experimental group: Lidocaine + standard of care
Experimental
Lidocaine hydrochloride 20 mg/mL, solution, 20 mL ampoule for intravenous administration Administration : parenteral route on peripheral or central venous catheter.
- Bolus of 1.5 mg/kg bolus during 30 minutes, with a maximum dose of 180 mg (18mL)
- Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h =- 12mL/h) during 72 hours.
干预措施: Standard of care (Drug)
结局指标
主要结局
Cumulative parenteral opioid dose between randomization and discharge from the intensive care unit expressed in morphine milligram equivalent.
时间窗: up to 28 days
To determine whether adding lidocaine to the standard of care in pain during severe vaso-occlusive crisis has an effect on the cumulative opioid consumption expressed as morphine milligram equivalent (MME)
次要结局
- hospital length of stay(up to 28 days)
- Visual analogue pain Scale score during Intensive Care Unit stay(up to 28 days)
- Categorical Pain Score during Intensive Care Unit stay(up to 28 days)
- Time of resolution of severe vaso-occlusive crisis(up to 28 days)
- time to last parenteral opioid dose(up to 28 days)
- vaso-occlusive crisis complications during Intensive Care Unit stay(up to 28 days)
- quality of life with reduced impact of Sickle Cell Disease on health(At Day 28)
- Rate of readmission for vaso-occlusive crisis after Intensive Care Unit discharge(At day 28)
- Assess the economic efficiency of lidocaine added to standard of care compared to standard of care alone(At day 28)
- Intensive Care Unit length of stay(up to 28 days)
- safety profile of lidocaine infusion(at 28 days)
- Intensive Care Unit length of stay(up to 28 days)
- hospital length of stay(up to 28 days)
- Visual analogue pain Scale score during Intensive Care Unit stay(up to 28 days)
- Categorical Pain Score during Intensive Care Unit stay(up to 28 days)
- Time of resolution of severe vaso-occlusive crisis(up to 28 days)
- time to last parenteral opioid dose(up to 28 days)
- vaso-occlusive crisis complications during Intensive Care Unit stay(up to 28 days)
- safety profile of lidocaine infusion(at 28 days)
- quality of life with reduced impact of Sickle Cell Disease on health(At Day 28)
- Rate of readmission for vaso-occlusive crisis after Intensive Care Unit discharge(At day 28)
- Assess the economic efficiency of lidocaine added to standard of care compared to standard of care alone(At day 28)
研究者
研究点 (32)
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