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Sponsored by: |
CAMC Health System |
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Information provided by: | CAMC Health System |
ClinicalTrials.gov Identifier: | NCT00799201 |
The purpose of this study is to determine if enteral naloxone is more effective than a traditional bowel regimen in the prevention and treatment of constipation and impaired gastric motility in critically ill trauma patients.
Condition | Intervention | Phase |
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Constipation Analgesia |
Drug: Naloxone and Docusate |
Phase IV |
Study Type: | Interventional |
Study Design: | Prevention, Randomized, Open Label, Parallel Assignment, Efficacy Study |
Official Title: | A Prospective, Randomized Trial of Enteral Naloxone Versus a Traditional Bowel Regimen in Prevention of Constipation and Decreased Gastric Motility in Critically Ill Trauma Patients |
Estimated Enrollment: | 176 |
Study Start Date: | August 2007 |
Estimated Study Completion Date: | December 2010 |
Estimated Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Control: Experimental
Sennosides liquid 5mL (8.8mg) every 6 hours plus docusate sodium liquid 10mL (100mg) every 12 hours
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Drug: Naloxone and Docusate
Naloxone 6mg (15 mL) every 6 hours plus docusate sodium liquid 10 mL (100mg) every 12 hours
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Impaired gastric motility and constipation are common issues among patients in the intensive care setting. Contributing factors include trauma, multiple surgical procedures, lack of ambulation, and the use of opiate analgesics to control pain. Common treatments for altered gastric motility and constipation include administration of pro-motility agents, stool softeners and bowel stimulants.
Enteral feeding is considered the safest and most effective way to provide nutrition to critically ill patients. Nutrition can be delayed and/or held when impaired gastric motility and constipation are present. Studies suggest that delays in the administration of nutrition can lead to prolonged ventilator time and increased length of stay in the intensive care setting as well as an increase in mortality.
Naloxone, a competitive opioid antagonist, is most commonly administered systemically to counteract the central and peripheral effects of opioids. When administered enterally naloxone has also been found to increase gastric emptying. Studies in patients receiving enteral feeds with multiple risk factors for altered gastric motility and constipation suggest that administration of enteral naloxone can reduce the incidence and extent of altered gastric motility and aid in defecation while not totally reversing the systemic effects of the opiate being administered. Due to these findings, it appears that enterally administered naloxone would provide a significant advantage over traditional gastrointestinal stimulants in preventing constipation in critically ill patients receiving continuous administration of opiate analgesics. In addition, the use of an enterally administered opiate antagonist may also alleviate the need for routine administration of pro-kinetic agents in order to promote adequate gastrointestinal motility and toleration of enterally administered nutrition. As a result, the comparison of enteral naloxone plus a stool softener versus a traditional bowel regimen containing a stimulant and stool softener will aid in assessing the effectiveness of opiate reversal locally in the gastrointestinal tract in prevention of decreased gastric motility and constipation.
Ages Eligible for Study: | 18 Years to 65 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Audis Bethea, PharmD,BCPS | 304-388-6260 | audis.bethea@camc.org |
United States, West Virginia | |
Charleston Area Medical Center, General Hospital | Recruiting |
Charleston, West Virginia, United States, 25301 |
Principal Investigator: | Audis Bethea, PharmD, BCPS | CAMC Health System |
Responsible Party: | Charleston Area Medical Center ( Audis Bethea, PharmD, BCPS ) |
Study ID Numbers: | 07-01-1897 |
Study First Received: | November 24, 2008 |
Last Updated: | January 15, 2009 |
ClinicalTrials.gov Identifier: | NCT00799201 |
Health Authority: | United States: Institutional Review Board |
Enteral nutrition Constipation Gastrointestinal motility Naloxone |
Docusate Bowel stimulant Stool softener |
Signs and Symptoms Signs and Symptoms, Digestive Critical Illness Constipation |
Wounds and Injuries Bismuth subsalicylate Naloxone |
Sensory System Agents Therapeutic Uses Physiological Effects of Drugs Narcotic Antagonists |
Peripheral Nervous System Agents Central Nervous System Agents Pharmacologic Actions |