Titrated Versus High and Low Dose Nebulized Morphine to Reduce Pain in Emergency Settings (TIMORNEB)
Post-Traumatic Headache, Acute Pain
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
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
Placebo Comparator
Experimental
Experimental
IV titrated morphine
Low dose nebulised morphine
High dose nebulised morphine
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.