Acute Pain Clinical Trial
Official title:
Single-dose and Multi-dose Open-label Pilot Trial of the Analgesic Efficacy and Tolerability of Intranasal Ketorolac Tromethamine (SPRIX®) in Dental Implant Surgery Patients With Postoperative Pain.
The surgical placement of dental implants is presently a common procedure performed by oral surgeons, periodontists, and general dentists. The surgery can be performed under local anesthesia and involves the incision of soft tissue to expose the underlying bone, preparation of the implant site using a specialized surgical drill, and.screwing the implant into bone using a specialized headpiece. Dental implant patients experience postoperative pain yet there are no studies in the literature which have evaluated the efficacy of analgesics in this patient population. The current pilot study will evaluate the analgesic effects and tolerability of a recently FDA-approved analgesic formulation of intranasal ketorolac (SPRIX®) in 25 patients who have 1 - 3 dental implants surgically placed. Patients will self administer the ketorolac nasal spray (one spray in each nostril, 31.5 mg total dose) when their postoperative pain reaches at least a moderate severity. Pain intensity and pain relief scores will then be recorded every 20 minutes for the first hour, at 1.5 and 2 hours and then hourly through 6 hours on a validated analgesic diary. Side effects will be recorded when and if they occur. Patients will then transition to a multi-dose phase where they will be allowed to dose with ketorolac as indicated in the package insert (up to 4 times per day for 5 days). Patients will record the time of each dose, a daily assessment of overall efficacy and side effects, and the use of any rescue medication (acetaminophen 650 mg) on a take home diary.
OBJECTIVES
1. Overall Objectives The purpose of this pilot study will be to evaluate the analgesic
efficacy and tolerability of intranasal ketorolac employed at doses and dosing
intervals stated in the package insert in patients experiencing moderate to severe pain
following dental implant surgery. This open label study should provide data that will
allow us to estimate sample size for a future placebo-controlled trial in the dental
implant surgery population.
2. Primary Outcome Variable(s) To determine if intranasal ketorolac significantly reduces
pain intensity scores when compared to baseline pain intensity as measured by the area
under the 6-hour pain intensity difference (SPID-6).
3. Secondary Outcome Variable(s) To determine the median onset of first perceptible,
confirmed first perceptible, and meaningful pain relief of intranasal ketorolac in
dental implant surgery patients.
To compare mean post-dose pain intensity scores at each time-point with the baseline pain
intensity score during the initial 6-hour evaluation period.
To calculate the area under the 6-hour pain relief time action curve (TOTPAR-6) for
intranasal ketorolac.
To calculate the percentage of subjects who reach a level of at least moderate pain by
achieving a score of at least 40 mm on a 100 mm visual analog scale within 5 hours after the
completion of surgery.
To determine the mean number of days of analgesic dosing in dental implant surgery patients
when employing intranasal ketorolac as their pain medication.
To determine the number of patients taking rescue medication (acetaminophen 650 mg) and the
mean number of rescue medication doses taken in dental implant surgery patients when
employing intranasal ketorolac as their pain medication.
To determine the overall tolerability of intranasal ketorolac in dental implant surgery
patients.
;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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