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

Primary Purpose

Pain, Acute

Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Methoxyflurane, MEOF
Sponsored by
Sunnybrook Health Sciences Centre
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pain, Acute

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

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

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Other

    Arm Label

    methoxyflurane

    Arm Description

    methoxyflurane

    Outcomes

    Primary Outcome Measures

    Patient satisfaction measured using the Patient Global assessment of Medication Performance (GMP)at the time of discharge
    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

    The Overall/Maximum pain intensity experienced at any point during the procedure using a numeric rating scale
    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
    Percent patients requiring rescue medication
    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
    Safety outcome measure to assess percentage of patients requiring rescue medication
    Documentation of adverse events as safety outcome measure by the health care professional
    Health professional impression of how well the medication worked measured using the Patient Global assessment of Medication Performance (GMP)at the time of discharge
    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 Scale
    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
    Assessment of how well the medication fulfilled the health care professional's expectations of pain relief using the Fulfillment of of Pain Relief Expectation Scale
    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

    Full Information

    First Posted
    April 22, 2020
    Last Updated
    June 1, 2020
    Sponsor
    Sunnybrook Health Sciences Centre
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04412642
    Brief Title
    Low Dose Methoxyflurane for Pain Relief During Minor Out-patient Urologic Procedures
    Official Title
    Pilot Study to Assess the Feasibility of Self-administered Low Dose Methoxyflurane for Pain Relief During Minor Out-patient Urologic Procedures
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2020
    Overall Recruitment Status
    Unknown status
    Study Start Date
    May 31, 2020 (Anticipated)
    Primary Completion Date
    September 30, 2020 (Anticipated)
    Study Completion Date
    December 31, 2020 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sunnybrook Health Sciences Centre

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    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

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Pain, Acute

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Masking Description
    no masking
    Allocation
    N/A
    Enrollment
    10 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    methoxyflurane
    Arm Type
    Other
    Arm Description
    methoxyflurane
    Intervention Type
    Drug
    Intervention Name(s)
    Methoxyflurane, MEOF
    Other Intervention Name(s)
    Penthrox
    Intervention Description
    As soon as possible following enrollment and initial procedures, the patient will be supplied with a PENTHROX™ kit which includes one inhaler containing 3 mL of MEOF for pain management. A member of the research team will train the patient to self-administer MEOF. PENTHROX™ is an approved (trademarked) product in Canada and is commercially available in a combination blister pack with one 3 mL sealed bottle and one PENTHROX™ inhaler with the Activated Carbon (AC) chamber.
    Primary Outcome Measure Information:
    Title
    Patient satisfaction measured using the Patient Global assessment of Medication Performance (GMP)at the time of discharge
    Description
    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
    Time Frame
    end of procedure
    Secondary Outcome Measure Information:
    Title
    The Overall/Maximum pain intensity experienced at any point during the procedure using a numeric rating scale
    Description
    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
    Time Frame
    during the procedure
    Title
    Percent patients requiring rescue medication
    Description
    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
    Time Frame
    during the procedure
    Title
    Safety outcome measure to assess percentage of patients requiring rescue medication
    Description
    Documentation of adverse events as safety outcome measure by the health care professional
    Time Frame
    During the procedure;post procedure and at 24 hours post procedure (phone contact)
    Title
    Health professional impression of how well the medication worked measured using the Patient Global assessment of Medication Performance (GMP)at the time of discharge
    Description
    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
    Time Frame
    end of procedure
    Title
    Assessment of how well the medication fulfilled the patient's expectations of pain relief using the Fulfillment of of Pain Relief Expectation Scale
    Description
    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
    Time Frame
    end of procedure
    Title
    Assessment of how well the medication fulfilled the health care professional's expectations of pain relief using the Fulfillment of of Pain Relief Expectation Scale
    Description
    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
    Time Frame
    end of procedure

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Conscious adult patients >= 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 Patient (patient/or patient's authorization legal representative) should understand the nature of the study and provide written informed consent Patient is able to follow all study requirements and procedures and complete required questionnaires Exclusion Criteria: An altered level of consciousness, due to any cause, including head injury, drugs,or alcohol Clinically significant renal impairment Women of child bearing potential who are pregnant or peri partum, including labour A history of liver dysfunction after previous MEOF use or other halogenated anesthetics Hypersensitivity to MEOF or other halogenated anesthetics, or to butylated hydroxytoluene Known or genetically susceptible to malignant hyperthermia or a history of severe adverse reactions in either patient or relatives Exacerbation of an underlying condition (i.e., chronic pain) Clinically evident or potential hemodynamic instability as per the opinion of the investigator Clinically evident respiratory impairment as per the opinion of the investigator Prior treatment with PENTHROX within 3 months
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Joanne M Lawrence, RN,BSc.
    Phone
    416-480-6100
    Ext
    2309
    Email
    joannelawrence@bell.net
    First Name & Middle Initial & Last Name or Official Title & Degree
    Sender Herschorn, MD,FRSC
    Phone
    416-480-4733
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Sender Herschorn, MD, FRSC
    Organizational Affiliation
    Sunnybrook Health Sciences Centre
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

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

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