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In the emergency department, 60% of patients have an acute pain. Appropriate management of acute pain is a public health priority according to who recommendations. Nebulized morphine has been extensively studied in children but less well in adults.
It offers a non-invasive route for systemic drug delivery, more rapid and less invasive than intravenous (IV) method.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nebulized Morphine | Experimental | After randomization, patients will receive 10 mg of morphine (1ml) diluted in 4 ml normal saline and nebulized with 6 l/mn during 10 min. Nebulization will be repeated systematically 3 times every twenty minutes unless the patient pain was resolved (VAPS 30%). In addition, patients receive a bolus of IV placebo(5 ml normal saline . IV placebo (2 ml) will be repeated every 10 minutes if the objective of analgesia was not reached . |
|
| Intravenous morphine | Active Comparator | After randomization, patients will receive a bolus of 5 mg of IV morphine (5 ml. Then, 2mg of IV morphine (2ml) will be added every 10 minutes if the objective of analgesia was not reached (VAPS >30%). In addition, normal saline (5ml)is nebulized with 6 l/mn during 10 min and will be repeated systematically every 20 minutes unless the patient's pain was not resolved (VAPS >30%). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| nebulized morphine | Drug | After randomization, patients will receive 10 mg of morphine (1ml) diluted in 4 ml normal saline and nebulized with 6 l/mn during 10 min. Nebulization will be repeated systematically 3 times every twenty minutes unless the patient pain was resolved (VAPS 30%). In addition, patients receive a bolus of IV placebo(5 ml normal saline . IV placebo (2 ml) will be repeated every 10 minutes if the objective of analgesia was not reached . |
| Measure | Description | Time Frame |
|---|---|---|
| 1. Resolution rate | resolution is defined as VAPS <30%. | one hour |
| Measure | Description | Time Frame |
|---|---|---|
| rate of side effects | Dyspnea, cutaneous rush, vomiting, nausea, pruritus and dizziness. | one hour |
| Resolution time | Resolution time is defined as the time between the starting of the protocol and pain decrease to a Visual Analog Scale less than 30% |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fattouma Bourguiba University Hospital | Monastir | Monastir Governorate | 5000 | Tunisia |
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| ID | Term |
|---|---|
| D010146 | Pain |
| D004630 | Emergencies |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020969 | Disease Attributes |
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|
| Intravenous morphine | Drug | After randomization, patients will receive a bolus of 5 mg of IV morphine (5 ml. Then, 2mg of IV morphine (2ml) will be added every 10 minutes if the objective of analgesia was not reached (VAPS >30%). In addition, normal saline (5ml)is nebulized with 6 l/mn during 10 min and will be repeated systematically every 20 minutes unless the patient's pain was not resolved (VAPS >30%). |
|
| one hour |
| D010335 | Pathologic Processes |