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Trial registered on ANZCTR
Registration number
ACTRN12605000292673
Ethics application status
Approved
Date submitted
26/08/2005
Date registered
5/09/2005
Date last updated
5/09/2005
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Hydromorphone Trial
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Scientific title
A Preliminary Crossover Study of the Pharmacokinetics and Clinical Efficacy of Hydromorphone Nasal Analgesia Spray versus Intravenous Hydromorphone for Postoperative Pain
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Analgesia for Postoperative Pain
380
0
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Condition category
Condition code
Alternative and Complementary Medicine
451
451
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Comparison of intranasal versus intravenous hydromorphone given in the postoperative period. Single-dose to be administered via first route (randomised order) at first onset of pain postoperatively, then single-dose via second route to be administered for pain between 12 and 24 hours later. Fentanyl PCIA for breakthrough pain in between these 2 doses.
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Intervention code [1]
277
0
Treatment: Drugs
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Comparator / control treatment
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Control group
Active
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Outcomes
Primary outcome [1]
512
0
Clinical effectiveness of a single dose of 2mg hydromorphone administered intranasally, as measured by redution of pain intensity at rest, compared with the administration of 1mg hydromorphone intravenously.
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Assessment method [1]
512
0
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Timepoint [1]
512
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Pain scores (visual analogue scale - VAS) will be collected immediately prior to (baseline) and at 5, 15, 30, 60, 120 and 180 minutes after each method of hydromorphone administration.
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Secondary outcome [1]
1098
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Nausea, sedation and pruritus scores (VAS).
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Assessment method [1]
1098
0
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Timepoint [1]
1098
0
Collected immediately prior to and 60 minutes after hydromorphone administration.
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Secondary outcome [2]
1099
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Presence of side effects including pain or burning in the nasal passages.
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Assessment method [2]
1099
0
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Timepoint [2]
1099
0
After intransal administration.
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Secondary outcome [3]
1100
0
Patient preference/acceptability - intranasal versus intravenous.
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Assessment method [3]
1100
0
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Timepoint [3]
1100
0
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Secondary outcome [4]
1101
0
Change in oxygen saturation post dose measured by pulse oximetry.
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Assessment method [4]
1101
0
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Timepoint [4]
1101
0
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Secondary outcome [5]
1102
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Drug Kinetics (bioavailability, volume of distribution, elimination) of intranasal hydromorphone.
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Assessment method [5]
1102
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Timepoint [5]
1102
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Blood sampled via IV cannula at 2, 5, 15, 30, 60, 120, 180 minutes after administration for both routes.
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Eligibility
Key inclusion criteria
ASA 1 or 2. Major Gynaecological Surgery involving skin or mucosal incision (e.g. laparotomy, total abdominal hysterectomy, vaginal hysterectomy +/- anterior/posterior repair).Decision to use patient controlled intravenous analgesia (PCIA) in the postoperative period.
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Nasal pathology.Allergy to shellfish (chitosan a natural constituent of mollusc seashell is added to the hydromorphone mixture to aid in prolonging mucosal absorption).Intolerance to opioids.Decision to use epidural analgesia postoperatively.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Opaque envelop used to conceal route of first administration until time of dose
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Latin Square Cross Over Design
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/07/2004
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
500
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Other Collaborative groups
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Name [1]
500
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ANZCA 2004 Grant
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Address [1]
500
0
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Country [1]
500
0
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Primary sponsor type
Individual
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Name
Stephen Lim
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Address
Senior Pharmacist
Pharmacy Department
Women & Children's Health Services
Subiaco
Perth WA 6008
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Country
Australia
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Secondary sponsor category [1]
409
0
Individual
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Name [1]
409
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Professor Michael Paech, King Edward Memorial Hospital
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Address [1]
409
0
374 Bagot Road, Subiaco, Perth, Western Australia, 6008
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Country [1]
409
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
1482
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King Edward Memorial Hospital
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Ethics committee address [1]
1482
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374 Bagot Road, Subiaco, Perth WA, 6008
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Ethics committee country [1]
1482
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Australia
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Date submitted for ethics approval [1]
1482
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Approval date [1]
1482
0
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Ethics approval number [1]
1482
0
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Summary
Brief summary
Hydromorphone is an opiate drug quite similar to morphine and is widely used to treat pain after surgery. A recent idea is to use a patient controlled technique which allows the patient to self-administer the drug as they need using a nasal spray. Previous studies show the absorption of hydromorphone through the nasal mucosa is rapid within a few minutes and that pain relief is very effective. The advantage of this route of delivery is that it avoids the use of intravenous drips. In this study we will be comparing the intravenous route of administration with what happens after a similar dose of hydromorphone is given intranasally. This will help to detemine the most appropriate way to prepare the nasal drug and the best dose to give with each spray. Postoperatively patients who are using patient controlled intravenous analgesia will be given a dose of hydromorphone for pain before they are allowed to start using their pump. All patients will get an intravenous and an intransal dose 12-24 hours apart. The order of which comes first will be randomly allocated. Blood wil be taken from a previously sited cannula at intervals before and after doses to measure levels. At all times good pain relief is guaranteed by use of the fentanyl PCIA.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
35378
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Address
35378
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Country
35378
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Phone
35378
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Fax
35378
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Email
35378
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Contact person for public queries
Name
9466
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Professor Michael Paech or Research Nurses, Desiree Cavill & Tracy Bingham
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Address
9466
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King Edward Memorial Hospital
374 Bagot Road
Subiaco Perth WA 6008
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Country
9466
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Australia
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Phone
9466
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+61 8 93402222 Pager 3223 (Mike Paech) or 3433 (Research Nurses)
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Fax
9466
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+61 8 93402260
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Email
9466
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[email protected]
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Contact person for scientific queries
Name
394
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Professor Michael Paech
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Address
394
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King Edward Memorial Hospital
374 Bagot Road
Subiaco Perth WA 6008
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Country
394
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Australia
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Phone
394
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+61 8 93402222 Pager 3223
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Fax
394
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+61 8 93402260
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Email
394
0
[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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