search
Back to results

Titrated Versus High and Low Dose Nebulized Morphine to Reduce Pain in Emergency Settings (TIMORNEB)

Primary Purpose

Post-Traumatic Headache, Acute Pain

Status
Completed
Phase
Not Applicable
Locations
Tunisia
Study Type
Interventional
Intervention
IV titrated morphine
Low dose nebulised morphine
High dose nebulised morphine
Sponsored by
University of Monastir
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Post-Traumatic Headache focused on measuring post traumatic pain, titrated morphine, nebulised morphine

Eligibility Criteria

8 Years - 50 Years (Child, Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • patients older than 8 years and less than 50 years
  • patients who consult emergency department for sever pain after an immediately trauma

Exclusion Criteria:

  • Glasgow coma scale <14
  • inability to cooperate
  • hypotension with systolic blood pressure< 90mmhg
  • bradypnea<12cpm
  • SAO2<90%
  • polytrauma
  • nasal trauma
  • rhinitis
  • nasal obstruction
  • allergy to opioids

Sites / Locations

  • Emergency Department

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

IV titrated morphine

Low dose nebulised morphine

High dose nebulised morphine

Arm Description

patient will receive 2 mg morphine each 5 min, associated to continuous nebulisation of saline serum (placebo). Morphine administration is stopped when VAS becomes under 50% and treatment failure is defined as VAS > 50%, 30 minutes after the beginning of the protocol.

patient will receive 10 mg of morphine prepared with 4 ml saline serum (SS) and nebulised with 6 l/min flow during 10 minutes. Nebulisation will be repeated 3 times, in addition, patients receive 2 ml IV SS every 5 minutes as placebo

patient will receive 20 mg of morphine prepared with 3 ml saline serum (SS) and nebulised with 6 l/min flow during 10 minutes. Nebulisation will be repeated 3 times, in addition, patients receive 2 ml IV SS every 5 minutes as placebo.

Outcomes

Primary Outcome Measures

Pain resolution
primary end point defined by the decrease in intensity pain objectified by a decline in visual analogy pain scale greater than or equal to 50% of its initial value

Secondary Outcome Measures

side effects
secondary outcomes combine the occurrence of side effects requiring discontinuation of treatment such as: dizziness, dyspnea, cutaneous rush, vomiting, nausea and pruritus.

Full Information

First Posted
July 22, 2014
Last Updated
November 26, 2014
Sponsor
University of Monastir
search

1. Study Identification

Unique Protocol Identification Number
NCT02200185
Brief Title
Titrated Versus High and Low Dose Nebulized Morphine to Reduce Pain in Emergency Settings
Acronym
TIMORNEB
Official Title
Efficacy and Safety of Nebulized Morphine Given at Two Different Doses Compared to Intravenous Morphine in Post-traumatic Acute Pain: a Randomized Controlled Double Blind Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2014
Overall Recruitment Status
Completed
Study Start Date
April 2012 (undefined)
Primary Completion Date
July 2014 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Monastir

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The investigators test a different technique using morphine to improve pain relief in patient visiting the emergency department with acute trauma pain, for this we are comparing three different methods of morphine administration: intravenous titrated morphine low dose nebulized morphine and high dose nebulized morphine
Detailed Description
Trauma patients are frequent in emergency department settings, and often require urgent care. taking care of this patients consists on taking care of their pain and then the specific treatment of their traumatic lesions. actually, the most used medicine and most efficient one in treating pain is morphine, it's mechanism of action is by acting on receptors located on neuronal cell membranes and inhibit neurotransmitter release. The most applied administration root of morphine is by intravenous (IV) titration or IV continuous perfusion, but until now, there is no clear recommendation concerning the superiority of this root over other administration techniques such as nebulization. In this study we aimed to investigate the efficiency, the feasibility and the tolerance of three morphine administration roots in patients with acute traumatic pain and to clarify the most adequate one to apply in emergency department settings.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Post-Traumatic Headache, Acute Pain
Keywords
post traumatic pain, titrated morphine, nebulised morphine

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
300 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IV titrated morphine
Arm Type
Placebo Comparator
Arm Description
patient will receive 2 mg morphine each 5 min, associated to continuous nebulisation of saline serum (placebo). Morphine administration is stopped when VAS becomes under 50% and treatment failure is defined as VAS > 50%, 30 minutes after the beginning of the protocol.
Arm Title
Low dose nebulised morphine
Arm Type
Experimental
Arm Description
patient will receive 10 mg of morphine prepared with 4 ml saline serum (SS) and nebulised with 6 l/min flow during 10 minutes. Nebulisation will be repeated 3 times, in addition, patients receive 2 ml IV SS every 5 minutes as placebo
Arm Title
High dose nebulised morphine
Arm Type
Experimental
Arm Description
patient will receive 20 mg of morphine prepared with 3 ml saline serum (SS) and nebulised with 6 l/min flow during 10 minutes. Nebulisation will be repeated 3 times, in addition, patients receive 2 ml IV SS every 5 minutes as placebo.
Intervention Type
Drug
Intervention Name(s)
IV titrated morphine
Other Intervention Name(s)
IV morphine group
Intervention Description
Intravenous morphine : 2 mg every 5 minutes by IV root and nebulized placebo: SS nebulised : 5 ml SS nebulised over 10 minutes and repeated 3 times
Intervention Type
Drug
Intervention Name(s)
Low dose nebulised morphine
Other Intervention Name(s)
Neb10
Intervention Description
10 mg morphine in 4 ml Serum Saline(SS) nebulised over 10 minutes and repeated 3 times, and SS IV placebo : 2 ml by IV root every 5 minutes
Intervention Type
Drug
Intervention Name(s)
High dose nebulised morphine
Other Intervention Name(s)
Neb20
Intervention Description
20 mg morphine in 3 ml serum saline (SS) nebulised over 10 minutes and repeated 3 times, and SS IV placebo : 2 ml by IV root every 5 minutes
Primary Outcome Measure Information:
Title
Pain resolution
Description
primary end point defined by the decrease in intensity pain objectified by a decline in visual analogy pain scale greater than or equal to 50% of its initial value
Time Frame
30 minutes
Secondary Outcome Measure Information:
Title
side effects
Description
secondary outcomes combine the occurrence of side effects requiring discontinuation of treatment such as: dizziness, dyspnea, cutaneous rush, vomiting, nausea and pruritus.
Time Frame
30 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
8 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: patients older than 8 years and less than 50 years patients who consult emergency department for sever pain after an immediately trauma Exclusion Criteria: Glasgow coma scale <14 inability to cooperate hypotension with systolic blood pressure< 90mmhg bradypnea<12cpm SAO2<90% polytrauma nasal trauma rhinitis nasal obstruction allergy to opioids
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nouira Semir, Professor
Organizational Affiliation
University of Monastir
Official's Role
Principal Investigator
Facility Information:
Facility Name
Emergency Department
City
Monastir
ZIP/Postal Code
5000
Country
Tunisia

12. IPD Sharing Statement

Citations:
PubMed Identifier
26143313
Citation
Grissa MH, Boubaker H, Zorgati A, Beltaief K, Zhani W, Msolli MA, Bzeouich N, Bouida W, Boukef R, Nouira S. Efficacy and safety of nebulized morphine given at 2 different doses compared to IV titrated morphine in trauma pain. Am J Emerg Med. 2015 Nov;33(11):1557-61. doi: 10.1016/j.ajem.2015.06.014. Epub 2015 Jun 14.
Results Reference
derived
Links:
URL
http://www.urgencemonastir.com
Description
official department site

Learn more about this trial

Titrated Versus High and Low Dose Nebulized Morphine to Reduce Pain in Emergency Settings

We'll reach out to this number within 24 hrs