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TerminatedNCT03756038Updated Mar 9, 2020Results posted

Benzodiazepines for the Reduction of Distress and Pain During and After Emergency Department Care

A Phase 2 interventional study of Placebos and Lorazepam in Acute Pain, sponsored by Maria Pacella. Terminated at 2 sites in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2020-03-09.

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

Why this study was terminated
It was not feasible to enroll Emergency Department patients into this protocol
Phase
Phase 2
Study type
Interventional
Enrollment
1
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 oral lorazepam reduces distress, pain severity, and need for opiate analgesics both in the ED and in the acute recovery period after discharge. The investigators will compare the lorazepam arm to a placebo arm.

Read the detailed description

The investigators will enroll 120 medically stable adult patients who present to two emergency departments with a physical injury (\< 24 hours ago) and a chief complaint of pain.

The investigators will randomly assign subjects using a blocked randomization schedule to either: 1) a single dose of oral lorazepam (1mg), or 2) oral placebo. Emergency department providers and patients will be blind to treatment allocation.

All participants will complete measures of negative affect and pain scores at baseline, and and 1 and 2 hours post-study drug administration. The investigators will record any analgesics administered in the emergency department until discharge. Patients will also undergo quantitative sensory testing in the Emergency Department at baseline, and after study drug administration. At 14-days post-discharge, the investigators will measure summary reports of pain, mood, and analgesic medication used.

02

Conditions studied

  • Acute Pain

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03

Who can participate

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

Inclusion criteria

  • Adults between the ages of 18-65
  • Sustained a physical injury with a pain score ≥ 5 on the numeric rating scale [NRS] from 0- 10 with anchors of 0 = "no pain" and 10 = "worst pain imaginable"
  • Expected to be in the ED for at least 2 hours, in a private treatment room
  • Ownership of a cell phone with text messaging capabilities
  • Emergency Department admission assessment confirmed subject is not suicidal.

Exclusion criteria

Exclusion Criteria:

  • Non-English speaking
  • Not medically suitable for lorazepam per treating MD (e.g. medical condition where benzodiazepines are contraindicated or may be unsafe)
  • Not alert and oriented
  • Active psychosis, self-injury, suicidal/homicidal intentions on initial evaluation by treating team
  • Seeking treatment due to a mental health or substance use disorder
  • History of chronic opioid use
  • Prescribed opioid or benzodiazepine use within the past 24 hours
  • Alcohol use within the past 12 hours or medical history of alcoholism.
  • Clinical indication for open-label benzodiazepine administration in the ED.
  • Any use of recreational narcotics throughout lifetime
  • Sensitivity or allergy or intolerance to opioids or benzodiazepines
  • Current neurological disease (e.g., multiple sclerosis, stroke, brain tumor, seizure disorder, etc.)
  • Prisoner
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
1 participant (actual)

Study arms

  • Experimental
    Drug: Oral Lorazepam (1mg)

    Lorazepam (Ativan) is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms.

    Drug: Lorazepam

  • Placebo comparator
    Drug: Oral Placebo

    Drug: Placebos

Interventions

  • DrugPlacebos

    In this study, patients will receive oral placebo, an inactive solution that looks like the study drug, but contains no active ingredients

  • DrugLorazepam

    The purpose of this study is to determine whether a single low dose of Lorazepam/Ativan (1mg) can relieve pain and reduce negative mood in the emergency department and for 2 weeks after emergency department treatment.

    Also known as: Ativan

05

What researchers measure

Primary outcomes

  1. Pain Severity in the Emergency Department: Numeric Rating Scale

    Pain Numeric Rating Scale (on a scale from 0, no pain to 10, worst pain imaginable)

    Time frame: The item is anchored to pain intensity "right now" at 60 minutes post-study drug administration

Secondary outcomes

  1. Negative Affect in the Emergency Department

    Positive and Negative Affect Schedule (PANAS)-We will use the 10 items of the Negative Affect Scale; each of these items are scored on a Likert Scale ranging from 1 (very slightly/not at all) to 5 (extremely). The responses for each of the 10 items are summed to create the Negative Affect Score; scores may range from 10-50, with lower scores representing lower scores of negative affect.

    Time frame: The 10 items of the Negative Affect Scale are anchored to mood "right now" at 60 minutes post-study drug administration.

06

Results

Posted Feb 26, 2020

Participant flow

Participant flow — Overall Study
MilestoneDrug: Oral Lorazepam (1mg)Drug: Oral Placebo
Started10
Completed10
Not completed00

Outcome measures

PrimaryPain Severity in the Emergency Department: Numeric Rating Scale

Pain Numeric Rating Scale (on a scale from 0, no pain to 10, worst pain imaginable)

Time frame:
The item is anchored to pain intensity "right now" at 60 minutes post-study drug administration
Reported as:
Number · units on a scale
Pain Severity in the Emergency Department: Numeric Rating Scale
units on a scaleDrug: Oral Lorazepam (1mg)Drug: Oral Placebo
Pain Severity in the Emergency Department: Numeric Rating Scale6—
SecondaryNegative Affect in the Emergency Department

Positive and Negative Affect Schedule (PANAS)-We will use the 10 items of the Negative Affect Scale; each of these items are scored on a Likert Scale ranging from 1 (very slightly/not at all) to 5 (extremely). The responses for each of the 10 items are summed to create the Negative Affect Score; scores may range from 10-50, with lower scores representing lower scores of negative affect.

Time frame:
The 10 items of the Negative Affect Scale are anchored to mood "right now" at 60 minutes post-study drug administration.
Reported as:
Number · units on a scale
Negative Affect in the Emergency Department
units on a scaleDrug: Oral Lorazepam (1mg)Drug: Oral Placebo
Negative Affect in the Emergency Department10—

Adverse events

Collected over 2-weeks of study duration. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Drug: Oral Lorazepam (1mg)0/1 (0%)0/1 (0%)0/1 (0%)
Drug: Oral Placebo———

Baseline characteristics

Due to feasibility issues, we had to prematurely halt enrollment.

Age, Continuous
Age, Continuous(years)Drug: Oral Lorazepam (1mg)Drug: Oral PlaceboTotal
Mean48 (48 to 48)—48 (48 to 48)
Sex: Female, Male
Sex: Female, Male(Participants)Drug: Oral Lorazepam (1mg)Drug: Oral PlaceboTotal
Female101
Male000
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Drug: Oral Lorazepam (1mg)Drug: Oral PlaceboTotal
Hispanic or Latino000
Not Hispanic or Latino101
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Drug: Oral Lorazepam (1mg)Drug: Oral PlaceboTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American000
White000
More than one race101
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)Drug: Oral Lorazepam (1mg)Drug: Oral PlaceboTotal
United States1—1
07

Study locations

2 sites
  • UPMC Presbyterian Hospital
    Pittsburgh, Pennsylvania 15213, United States
  • UPMC Mercy Hospital
    Pittsburgh, Pennsylvania 15219, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Feb 18, 2019

Documents are hosted by the registry — open the source record to download them.

Individual participant data

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

09

Registry details

Key details

Study ID
NCT03756038
Lead sponsor
Maria Pacella
Collaborators
University of Pittsburgh Physicians, University of Pittsburgh
Responsible party
Maria Pacella (Research Assistant Professor, University of Pittsburgh) — Sponsor-investigator
First posted
Nov 28, 2018
Start date
Jan 25, 2019
Primary completion
Mar 27, 2019
Completion
Mar 27, 2019
Results posted
Feb 26, 2020
Last update
Mar 9, 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 terminated, as verified in Feb 2020. You cannot join it, but the record below documents what was studied.

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