Protocol summary

Study aim
The comparison of the efficacy and adverse effects of intravenous ketorolac and ibuprofen in the pain management of patients with acute low back pain
Design
Two arm parallel group randomised trial and triple blinded
Settings and conduct
This is a triple blind study (patient, researcher and data statistician) in a way that the two medications applied in this study are colorless, odorless and prepared with the same volume and infused to the patients. The medications are prepared by a nurse who is not involved in the treatment or gathering the research information and the random code of the infused medication will be documented in the questionnaires. The data analyzer will assess the encoded data. The study will be implemented in the emergency department of Sina, Imam-Khomeini and Shariati hospitals in Tehran.
Participants/Inclusion and exclusion criteria
Participants are patients with acute low back pain (LBP) that did not report their pain for more than 3 months due to musculoskeletal or isolated trauma to the back. Furthermore, patients with increasing low back pain will be included in this study. Inclusion criteria: 1. Patients over 18 years-old 2. Patients with the complaint of musculoskeletal or isolated traumatic LBP 3. Patients having consented to enter the study Exclusion criteria: 1. Patients who have contraindications for Non-steroidal anti-inflammatory drugs (NSAIDs) 2. Pregnancy 3. Multiple trauma patients
Intervention groups
Group 1: Intravenous Ibuprofen: The administration of 2 cc sterile water in 30 seconds and then, 800 mg Ibuprofen in 500 cc normal saline in 30 minutes. Group 2: Intravenous Ketorolac: The administration of 30 mg Ketorolac in 2 cc syringe in 30 seconds and then, 500 cc normal saline in 30 minutes
Main outcome variables
pain score; drug adverse effects

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20151113025025N2
Registration date: 2018-09-30, 1397/07/08
Registration timing: prospective

Last update: 2018-09-30, 1397/07/08
Update count: 0
Registration date
2018-09-30, 1397/07/08
Registrant information
Name
Maryam Bahreini
Name of organization / entity
Tehran University of Medical Sciences, Sina Hospital
Country
Iran (Islamic Republic of)
Phone
+98 21 6312 1413
Email address
m-bahreini@tums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2018-10-23, 1397/08/01
Expected recruitment end date
2020-03-19, 1398/12/29
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
The comparison of the efficacy of intravenous ketorolac and ibuprofen in pain reduction in patients with acute low back pain presenting to the emergency department of Sina, Imam Khomeini and Shariati Hospitals in Tehran
Public title
The comparison of the efficacy of intravenous ketorolac and ibuprofen in pain reduction in patients with acute low back pain presenting to the emergency department of Sina, Imam Khomeini and Shariati Hospitals in Tehran
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
1. Patients who are over 18 years old. 2. Patients with low back pain due to musculoskeletal or isolated trauma to the back who present to the emergency department. 3. Patients who have completed ethical consent form to enter the study.
Exclusion criteria:
1. Patients who have contraindications for Non-steroidal anti-inflammatory drug (NSAIDs) administration including peptic ulcer, gastrointestinal bleeding, uncontrolled hypertension, renal disease, inflammatory bowel disease, hypersensitivity or allergy to NSAIDs, asthma 2. Pregnancy 3. Patients suffering from multiple trauma.
Age
From 18 years old
Gender
Both
Phase
3
Groups that have been masked
  • Participant
  • Care provider
  • Investigator
  • Outcome assessor
  • Data analyser
Sample size
Target sample size: 80
Randomization (investigator's opinion)
Randomized
Randomization description
Ketorolac and Ibuprofen ampules are prepared and placed in a 4 block sequence that is prepared by a nurse who knows the drug sequences according to a computerized random pattern but does not collect the results. These medications are restored in nearly 27 c in the emergency department. Then, the treating physician orders the next code analgesic from the block that will be infused according to the protocol we arranged. The treating physician documents the patients' demographic information and the diagnosis in the questionnaire form with the unique code of the medication that the patients received.
Blinding (investigator's opinion)
Triple blinded
Blinding description
This is a triple blind study (patient, researcher and data statistician) in a way that the two medications applied in this study are colorless, odorless and prepared with the same volume and infused to the patients so that they are indistinguishable. The medications are prepared by a nurse who is not involved in the treatment or gathering the research information and the random code of the infused medication will be documented in the questionnaires. The data analyzer will assess the encoded data and will not be informed of the medications. The analgesics of this study are as follows: - Intravenous Ibuprofen: The administration of 2 cc sterile water in 30 seconds and then, 800 mg Ibuprofen in 500 cc normal saline in 30 minutes. - Ketorolac: The administration of 30 mg Ketorolac in 2 cc syringe in 30 seconds and then, 500 cc normal saline in 30 minutes
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Tehran University of Medical Sciences
Street address
Emergency Department, Sina Hospital, Imam-Khomeini Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1136746911
Approval date
2018-09-06, 1397/06/15
Ethics committee reference number
IR.TUMS.MEDICINE.REC.1397.389

Health conditions studied

1

Description of health condition studied
Acute low back pain
ICD-10 code
ICD-10 code description

Primary outcomes

1

Description
Pain reduction
Timepoint
At the entrance to the emergency department, after 10, 30 and 60 minutes
Method of measurement
Pain intensity measured by Numeric rating scale

2

Description
Medication adverse effects
Timepoint
In the observation time
Method of measurement
Patient complaints of adverse effects during observation

Secondary outcomes

empty

Intervention groups

1

Description
Intervention group: Intravenous Ibuprofen
Category
Treatment - Drugs

2

Description
Intervention group: Intravenous Ketorolac
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Sina hospital
Full name of responsible person
Maryam Bahreini
Street address
Emergency department, Sina hospital, Imam-Khomeini Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1136546911
Phone
+98 21 6312 1413
Email
bahreinimaryam@gmail.com

2

Recruitment center
Name of recruitment center
Imam-Khomeini hospital
Full name of responsible person
Maryam Bahreini
Street address
Imam-Khomeini hospital, Keshavarz Blvd., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1419733141
Phone
+98 21 6690 4848
Email
bahreinimaryam@gmail.com

3

Recruitment center
Name of recruitment center
Shariati hospital
Full name of responsible person
Maryam Bahreini
Street address
Shariati hospital, Jalale-Ale-ahmad Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1411713135
Phone
+98 21 84901
Email
bahreinimaryam@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Dr. Mohammad Ali Sahraian
Street address
Vice Chancellor of Research and Technology, Qods Ave., Keshavarz Blvd., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1417653761
Phone
+98 21 8163 3698
Email
msahrai@tums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Tehran University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Maryam Bahreini
Position
Consultant
Latest degree
Specialist
Other areas of specialty/work
Emergency Medicine
Street address
Emergency department, Sina hospital, Imam-Khomeini Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1136546911
Phone
+98 21 6312 1413
Email
bahreinimaryam@gmail.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Maryam Bahreini
Position
Consultant
Latest degree
Specialist
Other areas of specialty/work
Emergency Medicine
Street address
Emergency department, Sina hospital, Imam-Khomeini Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1136546911
Phone
+98 21 6312 1413
Email
bahreinimaryam@gmail.com

Person responsible for updating data

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Maryam Bahreini
Position
Consultant
Latest degree
Specialist
Other areas of specialty/work
Emergency Medicine
Street address
Emergency department, Sina hospital, Imam-Khomeini Ave., Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1136546911
Phone
+98 21 6312 1413
Email
bahreinimaryam@gmail.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document
All data can be exposed anonymously.
When the data will become available and for how long
In the review process of the article
To whom data/document is available
Data will be only accessible for the researchers in the educational institutes.
Under which criteria data/document could be used
If the reviewers of journals request for the data, it will be sent for them anonymously.
From where data/document is obtainable
People can reach the data via an email request by declaring their rationale.
What processes are involved for a request to access data/document
People can reach the data via an email request by declaring their rationale. Data will be accessible in approximately 1 week by the researchers or reviewers.
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