Low Back Pain Clinical Trial
Official title:
Pamukkale University Medical School,Dept. of Emergency Medicine
This randomized, controlled trial evaluates the analgesic efficacy and safety of intravenous single-dose paracetamol, dexketoprofen and morphine for the treatment of low back pain.
Study Design and Setting:
This is a single-center, prospective, randomized, double-blind, clinical trial performed in
an ED of a tertiary care hospital with annual census of approximately 37.000 visits. The
local ethics committee approved the study.
Interventions:
We conducted a randomized, controlled clinical trial comparing single intravenous doses of
paracetamol (1 g), dexketoprofen (50 mg) and morphine (0.1 mg/kg) for patients presenting to
the emergency department (ED) with suspected low back pain. Subjects with inadequate pain
relief at 30 minutes received rescue fentanyl (0.75 microg/kg). We compared changes in pain
intensity 30 minutes after treatment.
Methods of Measurements:
Subjects reported pain intensity on both a 100-mm visual analogue scale (limited by 'no
pain' and 'the worst pain') and a 4-point verbal rating scale (no pain, mild, moderate, or
severe pain) just before the drug administration, 15th minutes and 30th minutes after the
study drug administration. The demographic features of study patients and adverse effects,
nausea, vomiting, dizziness, vertigo, headache, hypotension, altered mental status, allergic
reaction, itching, urinary retention, thoracic rigidity, respiratory depression and dry
mouth, were recorded to the study form.
Outcome Measures The primary outcome measure was the pain reduction in VAS and VRS at 15th
and 30th minutes. Secondary outcome measures were the need for rescue drug and the presence
of any adverse event.
Primary Data Analysis:
The present study was planned as a superiority trial. When the 20 mm difference in VAS is
accepted as clinically significant and the standard deviation is accepted as 25 mm, 35
patients are needed with each group with 95% power. All the analysis were implemented
according to the intention to treat analysis. The precise of differences between time
intervals within groups and between groups and statistical significance were expressed by
95% confidence intervals (95% CI).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Treatment
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