Sickle Cell Crisis Clinical Trial
Official title:
Evaluation of the Efficacy of Intra-nasal Sufentanil for Analgesia of Vaso-occlusive Crisis in Sickle-cell Adults.
The analgesic treatment for vaso-occlusive crisis (VOC) in sickle-cell patients is an emergency. The reference treatment is morphine, which requires a venous way sometimes difficult to obtain in these patients. Sufentanil intranasal has been shown to be effective in traumatology. The objective is to evaluate, in VOC, the efficacy of intranasal sufentanil relayed by morphine IV compared to the usual protocol, Equimolar Mixture of Oxygen-Nitrous Oxide (EMONO) relayed by morphine intravenous (IV).
Pain of VOC in sickle-cell patients seen in the emergency department (ED) is severe. Analgesia is a therapeutic emergency based on intravenous (IV) morphine titration. However, for technical reasons (patient flow in ED, difficult venous access) this treatment is often delayed. The Equimolar Mixture of Oxygen-Nitrous Oxide (EMONO), an inhaled analgesic administered, makes it possible to temporarily and very partially compensate for the major analgesic defect. Its efficacy in this indication has never been demonstrated; it is less effective than opiates during labour and is associated with a risk of addiction. The intranasal (IN) route is used to administer strong opiates such as sufentanil. Sufentanil IN has been shown to be rapidly effective in traumatology. Its duration of action is similar to that of morphine IV but its duration of action is far too short to completely replace it. Its ideal place would therefore be the initial phase of the management while waiting for a venous approach. The strategy is to propose an intranasal administration of an opioid (Sufentanil) at the initial management of vaso-occlusive crisis in sickle-cell patients in the ED waiting to a venous route for morphine. Follow-up of the study will be carried out in the ED with numeric rating scale (NRS) measurement every 5 minutes until patient relief (defined by NRS ≤ 3/10). Once relieved, NRS will be measured every 15 minutes for at least 2 hours. Treatment-related side effects will be systematically investigated up to 4 hours after starting treatment. In particular, the respiratory rate and level of consciousness will be measured, and all side effects will be recorded: nausea, vomiting, dizziness, behavioural disorders, pruritus. ;
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT01319448 -
Intermittent Preventive Treatment for Malaria in Patient With Sickle Cell Disease
|
Phase 1/Phase 2 | |
| Recruiting |
NCT05373771 -
Sickle Cell Improvement: Enhancing Care in the Emergency Department
|
N/A | |
| Completed |
NCT02316366 -
The Use of Warmed Saline in Vaso-occlusive Episodes
|
N/A | |
| Completed |
NCT05572294 -
Mindfulness and Yoga Therapy for Acute Pain in Sickle Cell Disease
|
N/A | |
| Not yet recruiting |
NCT05864092 -
Virtual Reality as an Adjuvant Therapy for Sickle Cell Vaso-Occlusive Crisis in the Pediatric Emergency Department
|
N/A | |
| Completed |
NCT03477552 -
Transillumination Device for Peripheral Intravenous Placement in Patients With Sickle Cell Disease (PERFID)
|
N/A | |
| Completed |
NCT03901560 -
Music Therapy: Sickle Cell and Pain Crisis
|
||
| Completed |
NCT02434939 -
Low-dose Ketamine vs Morphine for Vaso-occlusive Crisis in Sicklers
|
Phase 4 | |
| Completed |
NCT04330183 -
Low Dose Ketamine and Acute Pain Crisis
|
Phase 4 | |
| Not yet recruiting |
NCT04614610 -
Lidocaine Intravenous in the Emergency Department For Sickle Cell Crisis
|
Phase 2 | |
| Recruiting |
NCT03431285 -
Ketamine for Acute Painful Crisis in Sickle Cell Disease Patients
|
N/A | |
| Terminated |
NCT02698761 -
A Comprehensive Care Plan for Pediatric Patients With Vaso-Occlusive Crises
|
N/A |