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WithdrawnNCT01520298Updated Sep 30, 2014

Intravenous Acetaminophen as Adjuvant Therapy for Pain Control in Geriatric Hip Fracture Patients

A Phase 3 interventional study of Placebo and Acetaminophen IV in Pain and Hip Fracture, sponsored by Lancaster General Hospital. Withdrawn at 1 site in United States. Open to participants aged 65 Years and older. Per ClinicalTrials.gov, last updated 2014-09-30.

Sponsored by Lancaster General Hospital · Phase 3, Interventional, and Treatment

Why this study was withdrawn
Difficulty in recruiting subjects for the trial.
Phase
Phase 3
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
65 Years and older
Sex
All
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Study summary

This research study is a prospective, randomized, blinded, placebo controlled trial evaluating the benefit of IV acetaminophen (Ofirmev™) as adjuvant analgesia in geriatric hip fracture patients. IV acetaminophen has received FDA approval. IV acetaminophen does not have the liver toxicity as oral acetaminophen. No oral acetaminophen will be administered. All patients diagnosed with a hip fracture aged at least 65 years and expected to undergo surgical intervention are eligible to participate. Hip fractures affect greater than 300,000 geriatric patients annually, representing the second leading cause of hospitalization for this patient population. Pain control in these patients is often problematic due to co-morbidities and changes in their pharmacokinetic and pharmacodynamic profiles. Subjects may receive the normal DVT prophylactic treatments post-op.

Read the detailed description

Approximately 46 subjects will be enrolled at LGH. Subjects will be randomized 1:1 to receive either IV acetaminophen 1000 mg q6 hours (FDA recommended dose) or IV placebo. While receiving the study drug/placebo the subject's blood pressure, heart rate, respiratory rate, \& pain intensity will be monitored. Additional pain meds will be given if needed. Study treatment will continue until subject is taken into the operating room; at that time the intervention will be discontinued and other pain medication will be provided. Participation in the study will end at time of discharge from the hospital. Researchers are expecting a 33% decrease in opioid use for subjects randomized to treatment group.

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Conditions studied

  • Pain
  • Hip Fracture
03

In context

Pain

2,450 studies on the registry are indexed under Pain; 945 are open to participants now.

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Lead sponsor

Lancaster General Hospital is the lead sponsor of 21 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • All patients aged at least 65 years with a diagnosis of hip fracture with whom surgical intervention is expected
  • Patients with the following surgeons ( David Hughes MD, Gerald Rothacker MD, Frank Essis MD, James Carson MD, Michael Gish MD, Vincent Battista MD)

Exclusion criteria

Exclusion Criteria:

  • Documented drug or alcohol addiction or abuse
  • Documented serum sodium levels > 145 mmol/L
  • Documented serum chloride levels > 107 mmol/L
  • Impaired liver function defined as an ALT or AST > 3 times the upper limit of normal, Child-Pugh class C, or patients with documented active liver disease
  • Known allergy or intolerance to acetaminophen
  • Weight ≤ 50 kg
  • Creatinine clearance (CrCl) ≤ 30 ml/min as determined by the Cockcroft-Gault equation
  • Documented dementia
  • Acetaminophen (> 650 mg) or opioid (> 7 mg IV morphine equivalence) use within the previous 24 hours
  • Documented chronic opioid use
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
0 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    For the control group, a total of 100 mLs of 0.9% sodium chloride will be transferred to a Hospira LifeCare container and infused over 15 minutes (6.7 mL/min). A beyond use expiration of 6 hours will be placed on the container.

    Drug: Placebo

  • Active comparator
    Acetaminophen treatment

    For the treatment group, a total of 100 milliliters (mLs) of acetaminophen (1000 mg) will be transferred to a Hospira LifeCare container and infused over 15 minutes (6.7 mLs/min). A beyond use expiration of 6 hours at room temperature will place on the container, as recommended by the manufacturer.

    Drug: Acetaminophen IV

Interventions

  • DrugPlacebo

    For the control group, a total of 100 mLs of 0.9% sodium chloride will be transferred to a Hospira LifeCare container and infused over 15 minutes (6.7 mL/min). A beyond use expiration of 6 hours will be placed on the container. All admixture manipulations will be completed by the pharmaceutical staff according to the chapter 797 guidelines in the U.S. Pharmacopoeia. The treatment period will begin after admission and randomization, and will continue until surgical intervention.

  • For the treatment group, a total of 100 milliliters (mLs) of acetaminophen (1000 mg) will be transferred to a Hospira LifeCare container and infused over 15 minutes (6.7 mLs/min). A beyond use expiration of 6 hours at room temperature will place on the container, as recommended by the manufacturer. All admixture manipulations will be completed by the pharmaceutical staff according to the chapter 797 guidelines in the U.S. Pharmacopoeia. The treatment period will begin after admission and randomization, and will continue until surgical intervention.

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What researchers measure

Primary outcomes

  1. Opioid usage

    Participants will be assessed for opioid utilization until they go to surgery: an average of 24 hours.

    Time frame: 24 Hours

Secondary outcomes

  1. Length of stay

    Participants will be followed for the duration of their hospital stay, an expected average of 1 week. Length of stay, vital signs (blood pressure, heart rate, respiratory rate), pain scores using the visual analog scale (VAS), and opioid induced side effects including: nausea, vomiting, changes in blood pressure and delirium

    Time frame: Up to 1 week

  2. Vital signs

    Participants will be followed for the duration of their hospital stay, an expected average of 1 week. Length of stay, vital signs (blood pressure, heart rate, respiratory rate), pain scores using the visual analog scale (VAS), and opioid induced side effects including: nausea, vomiting, changes in blood pressure and delirium

    Time frame: Up to 1 week

  3. Pain scores

    Participants will be followed for the duration of their hospital stay, an expected average of 1 week. Length of stay, vital signs (blood pressure, heart rate, respiratory rate), pain scores using the visual analog scale (VAS), and opioid induced side effects including: nausea, vomiting, changes in blood pressure and delirium

    Time frame: Up to 1 week

  4. Opioid induced side effects

    Participants will be followed for the duration of their hospital stay, an expected average of 1 week. Length of stay, vital signs (blood pressure, heart rate, respiratory rate), pain scores using the visual analog scale (VAS), and opioid induced side effects including: nausea, vomiting, changes in blood pressure and delirium

    Time frame: Up to 1 week

07

Study locations

1 site
  • Lancaster General Hospital
    Lancaster, Pennsylvania 17604, United States
08

References and documents

Publications

  • Abbott C. Falls and hip fractures [updated: February 2011]. University of Missouri-Columbia School of Health Professions. Available at: http://www.vhct.org/case4007/index.htm. Accessed September 26, 2011.
  • Edelstein DM, Aharonoff GB, Karp A, Capla EL, Zuckerman JD, Koval KJ. Effect of postoperative delirium on outcome after hip fracture. Clin Orthop Relat Res. 2004 May;(422):195-200. doi: 10.1097/01.blo.0000128649.59959.0c. PubMed 15187857 ↗
  • Schuurmans MJ, Duursma SA, Shortridge-Baggett LM, Clevers GJ, Pel-Littel R. Elderly patients with a hip fracture: the risk for delirium. Appl Nurs Res. 2003 May;16(2):75-84. doi: 10.1016/s0897-1897(03)00012-0. PubMed 12764718 ↗
  • Morrison SR, Magaziner J, McLaughlin MA, Orosz G, Silberzweig SB, Koval KJ, Siu AL. The impact of post-operative pain on outcomes following hip fracture. Pain. 2003 Jun;103(3):303-311. doi: 10.1016/S0304-3959(02)00458-X. PubMed 12791436 ↗
  • Beaupre LA, Jones CA, Saunders LD, Johnston DW, Buckingham J, Majumdar SR. Best practices for elderly hip fracture patients. A systematic overview of the evidence. J Gen Intern Med. 2005 Nov;20(11):1019-25. doi: 10.1111/j.1525-1497.2005.00219.x. PubMed 16307627 ↗
  • Baumann T, Strickland J. Pain Management. In:DiPiro JT, et al., editors. Pharmacotherpay. 7th ed. New York: McGraw-Hill;2008. 989-1002
  • Chau DL, Walker V, Pai L, Cho LM. Opiates and elderly: use and side effects. Clin Interv Aging. 2008;3(2):273-8. doi: 10.2147/cia.s1847. PubMed 18686750 ↗
  • Ofirmev [package insert].San Diego, Ca: Cadence Pharmaceuticals; 2011
  • Sinatra RS, Jahr JS, Reynolds LW, Viscusi ER, Groudine SB, Payen-Champenois C. Efficacy and safety of single and repeated administration of 1 gram intravenous acetaminophen injection (paracetamol) for pain management after major orthopedic surgery. Anesthesiology. 2005 Apr;102(4):822-31. doi: 10.1097/00000542-200504000-00019. PubMed 15791113 ↗
  • Pettersson PH, Jakobsson J, Owall A. Intravenous acetaminophen reduced the use of opioids compared with oral administration after coronary artery bypass grafting. J Cardiothorac Vasc Anesth. 2005 Jun;19(3):306-9. doi: 10.1053/j.jvca.2005.03.006. PubMed 16130055 ↗
  • Singla N, Pong A, Newman K; MD-10 Study Group. Combination oxycodone 5 mg/ibuprofen 400 mg for the treatment of pain after abdominal or pelvic surgery in women: a randomized, double-blind, placebo- and active-controlled parallel-group study. Clin Ther. 2005 Jan;27(1):45-57. doi: 10.1016/j.clinthera.2005.01.010. PubMed 15763605 ↗
  • Cattabriga I, Pacini D, Lamazza G, Talarico F, Di Bartolomeo R, Grillone G, Bacchi-Reggiani L. Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. Eur J Cardiothorac Surg. 2007 Sep;32(3):527-31. doi: 10.1016/j.ejcts.2007.05.017. Epub 2007 Jul 23. PubMed 17643995 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 30, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01520298
Lead sponsor
Lancaster General Hospital
Responsible party
Michael A. Horst, PhD, MPHS, MS (Director of Research, Lancaster General Hospital) — Principal investigator
First posted
Jan 27, 2012
Start date
Dec 2011
Primary completion
May 2013
Completion
May 2013
Last update
Sep 30, 2014

Study contacts

Jennifer L Costello, PharmD
study chair · Lancaster General Hospital
Gerald W Rothacker, MD
principal investigator · Lancaster General Hospital
Jason Hall, PharmD
principal investigator · Lancaster General Hospital
Jill Rebuck, PharmD
principal investigator · Lancaster General Hospital
Michael A Horst, PhD
principal investigator · Lancaster General Hospital
Melody Dillman, RN
principal investigator · Lancaster General Hospital
Michael Gish, MD
principal investigator · Lancaster General Hospital
Vincent Batista, MD
principal investigator · Lancaster General Hospital
James H Carson, MD
principal investigator · Lancaster General Hospital
Frank M Essis, MD
principal investigator · Lancaster General Hospital
David P Hughes, MD
principal investigator · Lancaster General Hospital
Heidi L Testa, RN
principal investigator · Lancaster General Hospital
Kay M Knepper, RN
principal investigator · Lancaster General Hospital
LouAnne Kruse, RN
principal investigator · Lancaster General Hospital

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Acetaminophen

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