Is Paraspinal Intramuscular Ropivacaine Injection an Effective Treatment for Headache in a Pediatric Emergency Department? - Full Text View

Sponsor:	Children's Hospital of Pittsburgh
Information provided by:	Children's Hospital of Pittsburgh
ClinicalTrials.gov Identifier:	NCT00680823

Purpose

Objective: To determine if lower paracervical intramuscular ropivacaine injection is an effective treatment for pediatric headache in an emergency department setting.

Condition	Intervention
Headache Migraine	Drug: Ropivacaine Drug: Normal saline

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Is Paraspinal Intramuscular Ropivacaine Injection an Effective Treatment for Headache in a Pediatric Emergency Department?

Resource links provided by NLM:

Genetics Home Reference related topics: familial hemiplegic migraine

MedlinePlus related topics: Headache Migraine

Drug Information available for: Ropivacaine Ropivacaine monohydrochloride Ropivacaine Hydrochloride

U.S. FDA Resources

Further study details as provided by Children's Hospital of Pittsburgh:

Primary Outcome Measures:

The primary outcome will be pain relief sufficient for discharge from the emergency department. [ Time Frame: 3 hours ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

complete resolution of headache [ Time Frame: 3 hours ] [ Designated as safety issue: No ]
admission [ Time Frame: 3 hours ] [ Designated as safety issue: No ]
time from presentation to ultimate disposition [ Time Frame: 3 hours ] [ Designated as safety issue: No ]
re-presentation to the emergency department with headache within 72 hours of participating in the study [ Time Frame: 72 hours ] [ Designated as safety issue: No ]
a change of greater than 1.5 on the numerical rating scale [ Time Frame: 3 hours ] [ Designated as safety issue: No ]

Estimated Enrollment:	150
Study Start Date:	January 2009
Estimated Primary Completion Date:	July 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: A Intramuscular injection of the lower cervical paraspinous muscles with 1 mL of 0.5% ropivacaine on each side.	Drug: Ropivacaine 1 mL IM to each side in to the lower paraspinous muscles x 1.
Placebo Comparator: B Intramuscular injection of the lower cervical paraspinous muscles with 1 mL of normal saline on each side.	Drug: Normal saline 1 mL IM to each side in to the lower paraspinous muscles x 1.
No Intervention: C Observation for 30 minutes.

Detailed Description:

Methods: The study will be a double-blind randomized control trial. Patients will be randomly assigned to receive either intramuscular injection of the lower cervical paraspinous muscles with 1 mL of 0.5% ropivacaine on each side, placebo injections with 1 mL normal saline on each side, or no intervention at all. If randomized to an injection, the investigator and the patient will both be blinded as to the nature of the injection.

The location of the child's pain as well as severity will be assessed immediately prior to intervention and every 10 minutes for 30 minutes. If after 30 minutes relief is insufficient for discharge to home, intravenous treatment will be instituted according to current protocol. Pain will be reassessed at the time of ultimate disposition. The scale used to assess severity will vary based on the child's age.

Eligibility

Ages Eligible for Study:	7 Years to 18 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

Chief complaint of headache
Age 5-18 years

Exclusion Criteria:

Presence of fever
meningismus
headache that wakes the child at night
known organic brain disease, mass, or tumor
history of stroke
history of allergy to ropivacaine or other aminoacyl local anesthetics
history of liver disease
history of impaired cardiac function
abnormal neurologic signs
a focal neurologic abnormality on exam that is not a known component of the child's headache syndrome
cognitive inability to communicate the intensity of pain.
history of shunt or other intracranial hardware

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00680823

Contacts

Contact: Kerry Caperell, MD

412-692-5325

kerry.caperell@chp.edu

Locations

United States, Pennsylvania
Children's Hospital of Pittsburgh	Recruiting
Pittsburgh, Pennsylvania, United States, 15213
Contact: Kerry Caperell, MD 412-692-5325 kerry.caperell@chp.edu
Principal Investigator: Kerry Caperell, MD

Sponsors and Collaborators

Children's Hospital of Pittsburgh

Investigators

Principal Investigator:

Kerry Caperell, MD

Children's Hospital of Pittsburgh

More Information

No publications provided

Responsible Party:	Kerry Caperell, MD / Fellow - pediatric emergency medicine, Children's Hospital of Pittsburgh
ClinicalTrials.gov Identifier:	NCT00680823 History of Changes
Other Study ID Numbers:	PRO08030283
Study First Received:	May 16, 2008
Last Updated:	July 13, 2011
Health Authority:	United States: Institutional Review Board

Keywords provided by Children's Hospital of Pittsburgh:

Headache
Migraine
Ropivacaine

Additional relevant MeSH terms:

Emergencies
Headache
Migraine Disorders
Disease Attributes
Pathologic Processes
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Headache Disorders, Primary
Headache Disorders
Brain Diseases

Central Nervous System Diseases
Ropivacaine
Anesthetics, Local
Anesthetics
Central Nervous System Depressants
Physiological Effects of Drugs
Pharmacologic Actions
Sensory System Agents
Peripheral Nervous System Agents
Central Nervous System Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on February 09, 2012