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WithdrawnNCT03436121Updated Feb 11, 2020

Single-dose Ketamine for the Reduction of Pain and Depression in the Emergency Department

A Phase 2/3 interventional study of Ketamine and Midazolam in Acute Pain and Depression, sponsored by Maria Pacella. Withdrawn. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2020-02-11.

Sponsored by Maria Pacella · Phase 2/3, Interventional, and Treatment

Why this study was withdrawn
Ketamine shortage during the funding period of the trial
Phase
Phase 2/3
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

In this proposal, the investigators will determine if a single dose of intravenous (IV) ketamine (in combination with midazolam) reduces pain severity, depressive symptoms and need for opiate analgesics both in the ED and in the acute recovery period after ED discharge. The investigators will compare the ketamine arm to an active placebo-controlled arm (with midazolam).

Read the detailed description

The investigators will enroll 120 medically stable adult patients who present to two Emergency Departments with a chief complaint of acute pain.

The investigators will randomly assign subjects using a blocked randomization schedule to either: 1) a single dose of IV ketamine (0.3 mg.kg) + midazolam, or 2) placebo + midazolam. ED providers and patients will be blind to treatment allocation.

All participants will complete measures of pain and mood scores every 30 minutes, and the investigators will record any analgesics administered in the ED until discharge. At 7-days and 14-days post- discharge, the investigators will measure summary reports of pain severity, mood, and analgesic medication used.

02

Conditions studied

  • Acute Pain
  • Depression
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Adults between the ages of 18-65
  2. A chief complaint of painful condition (pain score ≥ 5 on the numeric rating scale [NRS] from 0-10 with anchors of 0 = "no pain" and 10 = "worst pain imaginable")
  3. Expected to be in the ED for at least 2 hours

Exclusion criteria

Exclusion Criteria:

  1. Non-English speaking
  2. Not medically suitable for ketamine per treating MD (e.g. medical condition where ketamine is contraindicated); ketamine or midazolam may be unsafe (e.g., known sensitivity, glaucoma, or other concerns)
  3. Not alert and oriented
  4. Active psychosis, self-injury, suicidal/homicidal intentions on initial evaluation by treating team
  5. Seeking treatment due to a mental health or substance use disorder
  6. History of chronic opioid use
  7. Prescribed opioid use within the past 24 hours
  8. Any use of recreational narcotics throughout lifetime
  9. Sensitivity or allergy or intolerance to ketamine, opioids, and/or benzodiazepines
  10. Weight > 170kg (375 lbs)
  11. Current neurological disease (e.g., multiple sclerosis, stroke, brain tumor, seizure disorder, etc.)
  12. Pregnancy
  13. Prisoner
04

Study design

Phase
Phase 2 / 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

  • Experimental
    Experimental Arm

    Participants will be assigned to receive a single dose of IV ketamine (0.3 mg.kg) + midazolam

    Drug: Ketamine · Drug: Midazolam

  • Active comparator
    Active Placebo Arm

    Participants will be assigned to receive a single dose of IV placebo + midazolam

    Drug: Midazolam · Drug: Placebo

Interventions

  • DrugKetamine

    Ketamine is a medication approved by the US Food and Drug Administration (FDA) for anesthesia, sedation, and post-surgical pain treatment. It is not approved for emergency patients complaining of pain but is often used "off-label." Ketamine may be useful for acute pain management and in treatment of depressed mood. The purpose of this study is to determine whether a single low dose of ketamine can relieve pain and reduce negative mood for 2 weeks after emergency department (ED) treatment.

  • DrugMidazolam

    In this study, all patients will also receive midazolam. Midazolam is a sedative that typically makes people feel relaxed and is intended to increase comfort with ketamine and reduce anxiety.

  • DrugPlacebo

    In this study, patients in the active comparator group will receive midazolam first, then placebo. A placebo is an inactive solution that looks like the study drug, but contains no active ingredients.

05

What researchers measure

Primary outcomes

  1. Pain Intensity in the ED

    Pain Numeric Rating Scale (PNRS)- this item is anchored to pain intensity "right now" on a scale from 0(no pain)-10 (worst pain imaginable)

    Time frame: Pain intensity rating in the ED at 1-hour post-study drug administration

Secondary outcomes

  1. Pain Intensity at Follow-Up

    Pain Numeric Rating Scale (PNRS): this item is anchored to pain intensity within the past 7-days on a scale from 0 (no pain) to 10 (worst pain imaginable)

    Time frame: Pain Intensity at 1-week post-ED Discharge

06

Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: Undecided — There is no plan in place yet because it is undecided whether the investigators will need to share the data with additional investigators/researchers not listed on the protocol.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03436121
Lead sponsor
Maria Pacella
Collaborators
University of Pittsburgh Physicians
Responsible party
Maria Pacella (Assistant Professor, University of Pittsburgh) — Sponsor-investigator
First posted
Feb 19, 2018
Start date
Dec 2019 (estimated)
Primary completion
Feb 5, 2020
Completion
Feb 5, 2020
Last update
Feb 11, 2020

Study contacts

Maria L Pacella, PhD
principal investigator · University of Pittsburgh

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is withdrawn, as verified in Feb 2020. You cannot join it, but the record below documents what was studied.

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