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Trial registered on ANZCTR
Registration number
ACTRN12620000042943
Ethics application status
Approved
Date submitted
19/12/2019
Date registered
21/01/2020
Date last updated
21/01/2020
Date data sharing statement initially provided
21/01/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Rapid Administration of Methoxyflurane to patients in Emergency Department (ED) Study (RAMPED)
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Scientific title
A Randomised Control Trial of Methoxyflurane vs Standard Care to assess the effect of the medication on the pain scores of patients at streaming
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Secondary ID [1]
300138
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Nil Known
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Universal Trial Number (UTN)
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Trial acronym
RAMPED
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pain
315668
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Condition category
Condition code
Emergency medicine
313959
313959
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0
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Other emergency care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patient is given a single dose of Methoxyflurane (3mL) via Inhaler device over 90 minutes, and the patient is assessed at set intervals during this time (at 15min, 30min, 60min and 90min since the commencement of medication) via a printed numeric rating scale of 0 (no pain) to 10 (worst pain imaginable), with all integers between 0 and 10, inclusive, available.
Intervention adherence will be assessed by the patient self-reporting - if there is a issue with fidelity, the research assistant/data collector will report as such on the case report form (CRF) and encourage the patient verbally to improve adherence to protocol.
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Intervention code [1]
316411
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Treatment: Drugs
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Comparator / control treatment
Standard Care
- Current management of patient includes giving simple analgesia such as Paracetamol or Ibuprofen
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Control group
Active
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Outcomes
Primary outcome [1]
322362
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The primary outcome will be defined as the proportion of participants achieving significant pain reduction, as assessed by a patient reported score via a printed numeric rating scale of 0 (no pain) to 10 (worst pain imaginable), with all integers between 0 and 10, inclusive, available. Participants’ reported pain scores will be recorded contemporaneously and the participants will not be reminded of the previous score. We consider significant pain reduction as at least a 50% drop in the initial pain score at 30 min from presentation to the ED.
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Assessment method [1]
322362
0
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Timepoint [1]
322362
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30 minutes since time of administration
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Secondary outcome [1]
378228
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Assess the duration of the effect of methoxyflurane usage on pain scores
The patient reported score, obtained via a printed numeric rating scale of 0 (no pain) to 10 (worst pain imaginable) with all integers between 0 and 10 inclusive available, will be assessed at the analysis stage by plotting the progression of the pain scores over the timepoints.
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Assessment method [1]
378228
0
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Timepoint [1]
378228
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15 minutes since time of administration
30 minutes since time of administration
45 minutes since time of administration
60 minutes since time of administration
90 minutes since time of administration
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Secondary outcome [2]
378731
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Assess if Methoxyflurane usage impacts upon the use of any other opioid analgesia in the ED
Data regarding the use of opioid analgesia is derived from the patient medical notes, and will be analysed against standard care use of opioids to assess differences in type, frequency and/or dose.
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Assessment method [2]
378731
0
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Timepoint [2]
378731
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15 minutes since time of administration
30 minutes since time of administration
45 minutes since time of administration
60 minutes since time of administration
90 minutes since time of administration
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Secondary outcome [3]
378736
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Mean pain score, obtained via a printed numeric rating scale of 0 (no pain) to 10 (worst pain imaginable) with all integers between 0 and 10 inclusive available
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Assessment method [3]
378736
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Timepoint [3]
378736
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30 minutes since time of administration
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Secondary outcome [4]
378737
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The proportion of participants achieving a drop in pain scores of at least 3 standard points on the numerical 11-point pain scale
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Assessment method [4]
378737
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Timepoint [4]
378737
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15 minutes since time of administration
30 minutes since time of administration
45 minutes since time of administration
60 minutes since time of administration
90 minutes since time of administration
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Eligibility
Key inclusion criteria
- Adult patients (aged greater than or equal to 18 years, and less than or equal to 75 years)
- Presentation to ED from home or scene of incident
- Initial pain score of 8/10 or greater
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Interhospital transfers
- Haemodynamic instability (cardiovascular instability, respiratory depression, head injury or impaired conscious state) defined as vital sign measurements that would be within met call criteria (e.g. HR<40 or >140, SBP<90 or >180, RR< 6 or >36, GCS<14)
- Pain possibly due to acute coronary syndrome
- Patients presenting with headache
- Pregnant patients or patients currently breastfeeding
- Known renal/hepatic failure
- Hypersensitivity to fluorinated anaesthetics
- Malignant hyperthermia
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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)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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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
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
4/09/2019
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Date of last participant enrolment
Anticipated
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Actual
16/01/2020
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Date of last data collection
Anticipated
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Actual
16/01/2020
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Sample size
Target
121
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Accrual to date
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Final
121
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
15550
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
28919
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
304575
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Hospital
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Name [1]
304575
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The Alfred Hospital’s Emergency & Trauma Centre
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Address [1]
304575
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55 Commercial Rd, Melbourne VIC 3004
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Country [1]
304575
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Medical Developments International
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Address
4 Caribbean Drive,
Scoresby, Vic, 3179, Australia
P.O. Box 9004,
Scoresby, Vic, 3179, Australia
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Country
Australia
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Secondary sponsor category [1]
304861
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None
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Name [1]
304861
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Address [1]
304861
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Country [1]
304861
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305001
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
305001
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55 Commercial Rd, Melbourne VIC 3004
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Ethics committee country [1]
305001
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Australia
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Date submitted for ethics approval [1]
305001
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17/12/2018
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Approval date [1]
305001
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10/01/2019
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Ethics approval number [1]
305001
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Summary
Brief summary
The Alfred Hospital is an adult major trauma centre, and receives in excess of 65,000 patient presentations per year. This study is an open-label randomised controlled trial of one dose of Methoxyflurane (3mL) administered after streaming to eligible patients compared to standard care. The primary outcome will be defined as the proportion of participants achieving significant pain reduction. We consider significant pain reduction as at least a 50% drop in the initial pain score at 30 min from presentation to the ED. Secondary outcomes will be the mean pain score at 30 min, the proportion of participants achieving a drop in pain scores of at least 3 standard points on the numerical 11-point pain scale, and the use of any opioid analgesia. Participants will be asked to indicate the intensity of pain at 30, 60, and 90 min after administration of analgesia, with a printed numeric rating scale of 0 (no pain) to 10 (worst pain imaginable), with all integers between 0 and 10, inclusive, available. Participants’ reported pain scores will be recorded contemporaneously and the participants will not be reminded of the previous score.
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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
98922
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Prof Biswadev Mitra
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Address
98922
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National Trauma Research Institute
85-89 Commercial Rd, Melbourne VIC 3004
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Country
98922
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Australia
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Phone
98922
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+61 03 9076 8806
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Fax
98922
0
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Email
98922
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[email protected]
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Contact person for public queries
Name
98923
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Biswadev Mitra
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Address
98923
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National Trauma Research Institute
85-89 Commercial Rd, Melbourne VIC 3004
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Country
98923
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Australia
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Phone
98923
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+61 03 9076 8806
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Fax
98923
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Email
98923
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[email protected]
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Contact person for scientific queries
Name
98924
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Biswadev Mitra
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Address
98924
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National Trauma Research Institute
85-89 Commercial Rd, Melbourne VIC 3004
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Country
98924
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Australia
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Phone
98924
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+61 03 9076 8806
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Fax
98924
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Email
98924
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
6238
Study protocol
[email protected]
6239
Ethical approval
[email protected]
6240
Clinical study report
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED) Study: A Randomized Controlled Trial of Methoxyflurane Versus Standard Care.
2021
https://dx.doi.org/10.1111/acem.14144
N.B. These documents automatically identified may not have been verified by the study sponsor.
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