Nasal Administration of Sufentanil+Ketamine for Procedure-related Pain in Children

Brief Summary

The aim of the study is to investigate the absorption and clinical effect of nasal administration of an analgesic nasal spray containing sufentanil+ketamine for pain related to medical procedures in hospitalized children.

Intervention / Treatment

  • Intranasal sufentanil/ketamine (DRUG)
    Nasal spray sufentanil+ketamine, 0,5 microg/kg sufentanil+0,5 mg/kg ketamine, single dose

Condition or Disease

  • Pain

Phase

  • Phase 2
  • Study Design

    Study type: INTERVENTIONAL
    Status: Completed
    Study results: No Results Available
    Age: 1 Year to 19 Years
    Enrollment: 50 (ACTUAL)
    Funded by: Other
    Allocation: N/A
    Primary Purpose: Treatment

    Masking

    Clinical Trial Dates

    Start date: Apr 01, 2010
    Primary Completion: Feb 01, 2013 ACTUAL
    Completion Date: Feb 01, 2013 ACTUAL
    Study First Posted: Jan 12, 2010 ESTIMATED
    Results First Posted: Sep 17, 2014 ESTIMATED
    Last Updated: Sep 12, 2014

    Sponsors / Collaborators

    Responsible Party: N/A

    The management of procedural pain in children ranges from physical restraint to pharmacological interventions. Pediatric formulations that permit accurate dosing, are accepted by children and a have a rapid onset of analgesia are lacking. The objectives were to investigate a pediatric formulation of intranasal sufentanil 0.5 mcg/kg and ketamine 0.5 mg/kg for procedural pain and to characterize the pharmacokinetic (PK) profile. Fifty children (≥10 kg) scheduled for a painful procedure were included in this prospective nonrandomized open-label clinical trial. Thirteen of these children had central venous access for drug assay sampling; enabling a compartmental PK analysis using nonlinear mixed-effects models. Pain intensity before and during the procedure was measured using age-appropriate pain scales. Heart rate, oxygen saturation and sedation were recorded.

    Participant Groups

    • Intranasal combination of sufentanil and ketamine. Dose of sufentanil 0.5 mcg/kg and ketamine 0.5 mg/kg, single dose.

    Eligibility Criteria

    Sex: All
    Minimum Age: 1
    Maximum Age: 19
    Age Groups: Child / Adult
    Healthy Volunteers: Yes

    Inclusion Criteria:

    * Children and adolescents treated at the University Hospital, Rigshospital
    * Painful medical procedure related to the patients treatment
    * Patient and/or the parents must be able to understand and speak danish
    * Negative pregnancy test for girls, when relevant
    * Signed informed consent
    * Only a light meals or no meals have been ingested 2 hours prior to inclusion

    Exclusion Criteria:

    * Allergy to sufentanil or ketamine
    * Abnormal nasal cavity
    * Have been treated with sufentanil and/or ketamine during the last 48 hours
    * Nasal obstruction (rhinitis)

    Primary Outcomes
    • Children \<5 years old were administered the FLACC (Face Leg Activity Cry Consolability) Scale (Range: 0-10, where 0 is no pain and 10 is worst pain). Children \>= 5 years but \< 8 years old were administered the Visual analog scale modified with six faces by Wong-Baker (Wong-Baker Faces Pain Rating Scale) (Range: 0-10, where 0 is no pain and 10 is worst pain). Children \>= 8 years old were administered a Visual Analog Scale (Range: 0-10, where 0 is no pain and 10 is worst pain).

    • Maximum Plasma Concentration (Cmax) of Sufentanil and Ketamine Time= 5-60 min after administration of the investigational medical product
    • Bioavailability of Sufentanil and Ketamine Time= 5-60 min after administration of the investigational medical product
    • Time to Maximum Plasma Concentrations (Tmax) Sufentanil and Ketamine Time=5-60 min after administration of investigational medicinal product
    Secondary Outcomes
    • University of Michigan Sedation Score (UMSS) (0-4, 0 "awake and alert", 4 "unarousable")

    • Asking the children (parents for preverbal children) if they would like to receive this treatment again in a similar situation rather than analgesic suppositories, tablets, oral solutions, or injections?

    More Details

    NCT Number: NCT01047241
    Other IDs: 201010
    Study URL: https://clinicaltrials.gov/study/NCT01047241
    Last updated: Sep 29, 2023