NCT05437575

Brief Summary

The Prehospital Analgesia INtervention trial (PAIN) is a proposed 4 year (3-year enrollment) multicenter, prehospital, randomized, double-blind, clinical trial that will enroll approximately 994 patients at select LITES Network sites. The objective is to perform a prospective, interventional, randomized trial among prehospital trauma patients with compensated shock (SI≥0.9 or HR ≥115) and an indication for pain management, comparing patient centered outcomes following prehospital administration of ketamine hydrochloride versus fentanyl citrate.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
994

participants targeted

Target at P75+ for phase_3

Timeline
37mo left

Started Nov 2023

Longer than P75 for phase_3

Geographic Reach
1 country

11 active sites

Status
recruiting

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 Progress46%
Nov 2023Jul 2029

First Submitted

Initial submission to the registry

May 24, 2022

Completed
1 month until next milestone

First Posted

Study publicly available on registry

June 29, 2022

Completed
1.4 years until next milestone

Study Start

First participant enrolled

November 27, 2023

Completed
4.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2028

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2029

Last Updated

March 9, 2026

Status Verified

March 1, 2026

Enrollment Period

4.6 years

First QC Date

May 24, 2022

Last Update Submit

March 5, 2026

Conditions

Keywords

Traumaketamine hydrochloridefentanyl citrateshockpain

Outcome Measures

Primary Outcomes (1)

  • 24-hour mortality

    All cause mortality within 24 hours from time of trauma bay arrival

    trauma bay arrival through 24 hours

Secondary Outcomes (16)

  • Hypoxia

    from initial administration of PAIN prehospital analgesia through hospital arrival

  • Hypotension

    from initial administration of PAIN study prehospital analgesia through hospital arrival

  • Need for airway management

    from initial administration of PAIN study prehospital analgesia through hospital arrival

  • Prehospital pain assessment following analgesia

    from initial administration of PAIN study prehospital analgesia through hospital arrival

  • Trauma bay arrival pain score

    score assessed at time of arrival to trauma bay

  • +11 more secondary outcomes

Study Arms (2)

Ketamine Hydrochloride

EXPERIMENTAL

2 blinded doses 2.5mg/ml ketamine hydrochloride in separately sealed pre-filled syringes Subjects will be administered the first dose over approximately 2 minutes via slow IV push. Pain assessment following administration will be obtained and recorded every 15 minutes. Redosing may occur after approximately 15 minutes if the subject has a qualifying pain score, there are no contraindications to pain medication per local protocol, and no exclusion criteria have been met.

Drug: Ketamine Hydrochloride

Fentanyl Citrate

ACTIVE COMPARATOR

2 blinded doses 10mcg/ml in separately sealed pre-filled syringes Subjects will be administered the first dose over approximately 2 minutes via slow IV push. Pain assessment following administration will be obtained and recorded every 15 minutes. Redosing may occur after approximately 15 minutes if the subject has a qualifying pain score, there are no contraindications to pain medication per local protocol, and no exclusion criteria have been met.

Drug: Fentanyl Citrate

Interventions

ketamine hydrochloride 2.5mg/ml packaged in pre-filled syringe

Ketamine Hydrochloride

fentanyl citrate 10mcg/ml packaged in pre-filled syringe

Fentanyl Citrate

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Transport after injury to a participating PAIN Trauma center
  • \. Patient with compensated shock as defined by Shock Index (SI) ≥0.9 or Heart Rate (HR) ≥115.
  • Intravenous pain medication indicated (CPOT≥2, NRS≥5) prior to arrival at the trauma center

You may not qualify if:

  • No IV access
  • Age \<18 years
  • Females \<50 years of age
  • SBP\>180 mmHg at time of enrollment
  • Advanced airway management prior to first dose administration
  • Known allergy to fentanyl citrate or ketamine hydrochloride
  • Known prisoner
  • Objection to study voiced by subject or family member at scene
  • Pain treatment contraindicated by local protocol
  • Wearing a "NO PAIN STUDY" bracelet

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (11)

University of California, San Diego

San Diego, California, 92103, United States

RECRUITING

Zuckerberg San Francisco General Hospital

San Francisco, California, 94110, United States

RECRUITING

Cooper University Health Care

Camden, New Jersey, 08103, United States

RECRUITING

Atrium Health and Carolinas Medical Center

Charlotte, North Carolina, 28203, United States

RECRUITING

University of Cincinnati

Cincinnati, Ohio, 45267, United States

RECRUITING

Allegheny Health Network (AHN) Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212, United States

RECRUITING

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

RECRUITING

Guthrie Robert Packer Hospital

Sayre, Pennsylvania, 18840, United States

RECRUITING

University of Utah

Salt Lake City, Utah, 84132, United States

RECRUITING

The University of Vermont Larner College of Medicine

Burlington, Vermont, 05405, United States

RECRUITING

Medical College of Wisconsin

Milwaukee, Wisconsin, 53266, United States

SUSPENDED

MeSH Terms

Conditions

Wounds and InjuriesShockPain

Interventions

KetamineFentanyl

Condition Hierarchy (Ancestors)

Pathologic ProcessesPathological Conditions, Signs and SymptomsNeurologic ManifestationsSigns and Symptoms

Intervention Hierarchy (Ancestors)

CyclohexanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsPiperidinesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Officials

  • Jason Sperry, MD

    University of Pittsburgh

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Jason Sperry, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, CARE PROVIDER
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Parallel Assignment
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

May 24, 2022

First Posted

June 29, 2022

Study Start

November 27, 2023

Primary Completion (Estimated)

July 1, 2028

Study Completion (Estimated)

July 1, 2029

Last Updated

March 9, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will share

De-identified data may be shared with the funding agency as well as other researchers upon request to the Principal Investigator

Shared Documents
STUDY PROTOCOL, ICF
Time Frame
Data will become available after publication of the primary manuscript
Access Criteria
Requests for data will be submitted in writing and reviewed by the Principal Investigator.

Locations