NCT00701909

Brief Summary

This is a randomized double-blind study to determine if the administration of a small-dose of ketamine (an anesthetic)added to morphine (an opioid) contributes to reducing pain intensity during open wound care procedure (WCP)in patients who have had a traumatic injury and are in an Intensive Care Unit. Patients will be randomized to receive morphine plus saline (a placebo) or morphine plus ketamine before the WCP. The second time the patient is scheduled for WCP (no less than 24 hours), patients will be crossed over to receive the treatment they did not receive the first time. It is hypothesized that patients who receive the combination of morphine and ketamine will have better pain control during the procedure than patients who just receive morphine.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
12

participants targeted

Target at below P25 for phase_3

Timeline
Completed

Started Jun 2008

Shorter than P25 for phase_3

Geographic Reach
2 countries

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2008

Completed
17 days until next milestone

First Submitted

Initial submission to the registry

June 18, 2008

Completed
1 day until next milestone

First Posted

Study publicly available on registry

June 19, 2008

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2009

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2009

Completed
15 years until next milestone

Results Posted

Study results publicly available

March 26, 2024

Completed
Last Updated

March 26, 2024

Status Verified

March 1, 2024

Enrollment Period

10 months

First QC Date

June 18, 2008

Results QC Date

February 7, 2024

Last Update Submit

March 25, 2024

Conditions

Keywords

wound careprocedural pain intensityprocedural hyperalgesiawound care pain intensitywound care hyperalgesiaWound care pain qualityLevel of drowsinesslevel of nauseaLevel of vomitingLevel of hallucinationsLevel of dysphoria

Outcome Measures

Primary Outcomes (1)

  • Pain Intensity

    The degree of pain described by participants on a numeric rating scale of 0 to 10, where 0 = no pain and 10 = worst pain imaginable

    Immediately after the wound care procedure

Secondary Outcomes (1)

  • Wound Pain Quality

    Immediately after the procedure

Study Arms (2)

Morphine plus Ketamine, then Morphine plus Saline (placebo)

ACTIVE COMPARATOR

During the first wound care procedure, patients received morphine 0.05 mg/kg (a maximum dose of 4 mg) plus ketamine 0.25 mg/kg (MK). Then, during the second wound care procedure, patients received morphine 0.1 mg/kg (a maximum dose of 8 mg) plus saline (MS).

Drug: Morphine plus KetamineDrug: Morphine plus Saline (placebo)

Morphine plus Saline (placebo), then Morphine plus Ketamine

PLACEBO COMPARATOR

During the first wound care procedure, patients received morphine 0.1 mg/kg (a maximum dose of 8 mg) plus saline (MS). Then, during the second wound care procedure, patients received morphine 0.05 mg/kg (a maximum dose of 4mg) plus ketamine 0.25 mg/kg (MK)

Drug: Morphine plus KetamineDrug: Morphine plus Saline (placebo)

Interventions

Morphine 0.05 mg/kg (maximum dose of 4 mg) IV plus Ketamine 0.25 mg/kg IV. Then, Morphine 0.1 mg/kg (maximum dose of 8 mg) IV plus Saline IV

Morphine plus Ketamine, then Morphine plus Saline (placebo)Morphine plus Saline (placebo), then Morphine plus Ketamine

Morphine 0.1 mg/kg (maximum dose of 8 mg) IV plus Saline IV. Then, Morphine 0.05 mg/kg (maximum dose of 4 mg) IV plus Ketamine 0.25 mg/kg IV.

Morphine plus Ketamine, then Morphine plus Saline (placebo)Morphine plus Saline (placebo), then Morphine plus Ketamine

Eligibility Criteria

Age21 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adults patients (≥ 21 years) have to have an open wound with duration of no more than 10 days that requires wound care
  • be able to self-report their pain
  • had a pain intensity score \> 3 during previous wound care procedure
  • has intravenous access

You may not qualify if:

  • Patients with an injury that impairs sensation in the wound area according to a medical diagnosis
  • has an allergy to morphine or ketamine
  • has not received morphine previously
  • In addition, patients who are 65 years of age or older.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of California San Francisco

San Francisco, California, 94143-0610, United States

Location

Trauma Hospital Puerto Rico Medical Center

San Juan, Puerto Rico

Location

Related Publications (1)

  • Arroyo-Novoa CM, Figueroa-Ramos MI, Miaskowski C, Padilla G, Paul SM, Rodriguez-Ortiz P, Stotts NA, Puntillo KA. Efficacy of small doses of ketamine with morphine to decrease procedural pain responses during open wound care. Clin J Pain. 2011 Sep;27(7):561-6. doi: 10.1097/AJP.0b013e318211936a.

MeSH Terms

Conditions

PainHyperalgesiaNauseaVomitingHallucinations

Interventions

MorphineKetamineSodium Chloride

Condition Hierarchy (Ancestors)

Neurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsSomatosensory DisordersSensation DisordersNervous System DiseasesSigns and Symptoms, DigestivePerceptual DisordersNeurobehavioral Manifestations

Intervention Hierarchy (Ancestors)

Morphine DerivativesMorphinansOpiate AlkaloidsAlkaloidsHeterocyclic CompoundsHeterocyclic Compounds, Bridged-RingHeterocyclic Compounds, 4 or More RingsHeterocyclic Compounds, Fused-RingPhenanthrenesPolycyclic Aromatic HydrocarbonsPolycyclic CompoundsCyclohexanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsChloridesHydrochloric AcidChlorine CompoundsInorganic ChemicalsSodium Compounds

Limitations and Caveats

The sample size was small, and all patients were male. Blinding was challenging to assure when patients demonstrated adverse effects associated with ketamine. In addition, because different orthopedic technicians performed the WCPs, the effect of the variability in the procedure technique on pain could not be controlled.

Results Point of Contact

Title
Dr. Kathleen Puntillo, RN, PhD
Organization
University of California, San Francisco

Study Officials

  • Kathleen A Puntillo, RN, DNSc

    Regents of the University of California, San Francisco

    STUDY CHAIR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 18, 2008

First Posted

June 19, 2008

Study Start

June 1, 2008

Primary Completion

April 1, 2009

Study Completion

April 1, 2009

Last Updated

March 26, 2024

Results First Posted

March 26, 2024

Record last verified: 2024-03

Data Sharing

IPD Sharing
Will not share

Locations