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Sponsored by: |
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) |
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Information provided by: | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) |
ClinicalTrials.gov Identifier: | NCT00383682 |
Persistent pain occurs in 50-85 percent of patients who experience the amputation of an extremity. This study will compare the effectiveness of morphine and mexiletine to placebo in the treatment of postamputation pain. It is hypothesized that the effects of opioids and mexiletine on behavior and mental functioning in patients with postamputation pain are unlikely to be significant barriers to the clinical use of the drugs.
Condition | Intervention | Phase |
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Amputation Chronic Pain |
Drug: morphine and mexiletine |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double-Blind, Placebo Control, Crossover Assignment, Safety/Efficacy Study |
Official Title: | Randomized, Placebo-Controlled, Double-Blind Cross-Over Trial of Opioids Versus Mexiletine in the Treatment of Postamputation Pain |
Estimated Enrollment: | 60 |
Study Start Date: | July 1997 |
Estimated Study Completion Date: | April 2003 |
The long-term objective of this research is to develop better clinical strategies for alleviating pain resulting from amputation of extremities.
Amputation is the most radical form of nerve injury. The two major types of postamputation painful sequela are phantom pain and stump pain. Phantom pain has been defined as painful sensation perceived in the missing body part, or portion thereof (Merskey and Bogduk,1994). Phantom pain is the most distressing, and often difficult to treat, chronic neuropathic pain syndrome that results from direct injury to the peripheral or central nervous system.
Recent epidemiological studies indicate that 50-85% of patients experience persistent pain following amputations. This controlled clinical trial will examine the role of opioid analgesics and local anesthetics in the treatment of phantom and associated stump pain resulting from amputations.
Specifically, our objectives are to answer the following questions:
Ages Eligible for Study: | 18 Years to 85 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Adults (18 years or older) of both sexes and all races with persistent phantom and or stump pain for 6 months or longer following an amputation will be eligible for enrollment in the study.
Exclusion Criteria:
1) age less than 18 or over 85 years, 2) history of allergic reaction to the study drugs, i.e., morphine and mexiletine, 3) cardiac conduction defects such as second degree or complete heart block, or a myocardial infarction in the last 3 months, 4) severe pulmonary disease, 5) current history of alcohol or substance abuse, 6) seizures, dementia or encephalopathy, 7) pregnancy and nursing mothers, 8) chronic hepatic disease or hepatic failure, 9) hematological disease associated with leukopenia and/or thrombocytopenia, and 10) other terminal illness with a life expectancy of less than 6 months. 11) Finally, to avoid a bias in patient selection, patients who failed to achieve clinically significant pain relief to a previous optimal trial with morphine and/or mexiletine will be excluded. An optimal trial will be defined as minimum of 3 week trial with either agent using a drug titration paradigm where the dose of the drugs were increased at intervals of one week or less.
Study ID Numbers: | P01HD33990, Project 2, P01HD33990 |
Study First Received: | September 29, 2006 |
Last Updated: | September 29, 2006 |
ClinicalTrials.gov Identifier: | NCT00383682 History of Changes |
Health Authority: | United States: Federal Government |
postamputation pain phantom pain stump pain |
neuroma pain opioid mexiletine |
Morphine Central Nervous System Depressants Mexiletine Pain Peripheral Nervous System Agents Cardiovascular Agents |
Anti-Arrhythmia Agents Analgesics Phantom Limb Neuroma Analgesics, Opioid |
Sensory System Agents Therapeutic Uses Physiological Effects of Drugs Central Nervous System Depressants Mexiletine Peripheral Nervous System Agents |
Analgesics Cardiovascular Agents Anti-Arrhythmia Agents Central Nervous System Agents Pharmacologic Actions Analgesics, Opioid |