Trial Outcomes & Findings for Study of Fentanyl-Propofol-EMLA of L.M.X4 Technique for Bone Marrow Aspiration (NCT NCT00187135)

NCT ID: NCT00187135

Last Updated: 2017-04-04

Results Overview

During the sedation recovery period, pain was measured by one of three validated pediatric scales. Scales were applied according to the developmental ability of the participant: Numerical Pain Scale, FACES pain scale, and FLACC pain scale (a score based on behaviors observed: face, legs, activity, cry, and consolability). All three scales are scored from 0 - 10 units on a scale, and are interchangeable for comparison purposes. Any score \>0 was coded "pain", and score of 0 was coded "no pain", yielding one score for each participant's procedure.

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

168 participants

Primary outcome timeframe

The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Results posted on

2017-04-04

Participant Flow

A total of 168 participants were enrolled between March, 2002 and August, 2007.

168 participants were enrolled and were expected to receive 3 Bone Marrow Aspirations/Lumbar Puncture Intrathecal Chemotherapy procedures; 6 patients withdrew (eg: medical withdrawal, withdrawal of consent and other). 162 were randomized, of which 77 completed all 3 treatments.

Participant milestones

Participant milestones
Measure
Fentanyl 0.5 / Placebo / Fentanyl 1
Participants assigned to receive Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their first visit, Placebo (Pl)during their second visit, and Fentanyl 1 micrograms per kilogram at the final visit.
Fentanyl 0.5 /Fentanyl 1 / Placebo
Participants assigned to receive Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their first visit, Fentanyl 1 micrograms per kilogram (mcg/kg) during their second visit, and Placebo at the final visit.
Placebo / Fentanyl 0.5 /Fentanyl 1
Participants assigned to receive Placebo during their first visit, Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their second visit, and Fentanyl 1 micrograms per kilogram (mcg/kg) at the final visit.
Placebo /Fentanyl 1 / Fentanyl 0.5
Participants assigned to receive Placebo during their first visit, Fentanyl 1 micrograms per kilogram (mcg/kg) during their second visit, and Fentanyl 0.5 micrograms per kilogram (mcg/kg) at the final visit.
Fentanyl 1 / Fentanyl 0.5 / Placebo
Participants assigned to receive Fentanyl 1 micrograms per kilogram (mcg/kg) during their first visit Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their second visit, and Placebo at the final visit.
Fentanyl 1 / Placebo /Fentanyl 0.5
Participants assigned to receive Fentanyl 1 micrograms per kilogram (mcg/kg) during their first visit Placebo during their second visit, and Fentanyl 0.5 micrograms per kilogram (mcg/kg) at the final visit.
Visit One
STARTED
30
28
25
26
25
28
Visit One
COMPLETED
26
27
25
26
25
26
Visit One
NOT COMPLETED
4
1
0
0
0
2
Visit Two
STARTED
26
27
25
26
25
26
Visit Two
COMPLETED
21
24
23
18
19
18
Visit Two
NOT COMPLETED
5
3
2
8
6
8
Visit Three
STARTED
21
24
23
18
19
18
Visit Three
COMPLETED
14
17
14
9
11
12
Visit Three
NOT COMPLETED
7
7
9
9
8
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Fentanyl 0.5 / Placebo / Fentanyl 1
Participants assigned to receive Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their first visit, Placebo (Pl)during their second visit, and Fentanyl 1 micrograms per kilogram at the final visit.
Fentanyl 0.5 /Fentanyl 1 / Placebo
Participants assigned to receive Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their first visit, Fentanyl 1 micrograms per kilogram (mcg/kg) during their second visit, and Placebo at the final visit.
Placebo / Fentanyl 0.5 /Fentanyl 1
Participants assigned to receive Placebo during their first visit, Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their second visit, and Fentanyl 1 micrograms per kilogram (mcg/kg) at the final visit.
Placebo /Fentanyl 1 / Fentanyl 0.5
Participants assigned to receive Placebo during their first visit, Fentanyl 1 micrograms per kilogram (mcg/kg) during their second visit, and Fentanyl 0.5 micrograms per kilogram (mcg/kg) at the final visit.
Fentanyl 1 / Fentanyl 0.5 / Placebo
Participants assigned to receive Fentanyl 1 micrograms per kilogram (mcg/kg) during their first visit Fentanyl 0.5 micrograms per kilogram (mcg/kg) during their second visit, and Placebo at the final visit.
Fentanyl 1 / Placebo /Fentanyl 0.5
Participants assigned to receive Fentanyl 1 micrograms per kilogram (mcg/kg) during their first visit Placebo during their second visit, and Fentanyl 0.5 micrograms per kilogram (mcg/kg) at the final visit.
Visit One
Withdrawal by Subject
1
0
0
0
0
1
Visit One
Physician Decision
3
1
0
0
0
1
Visit Two
Death
0
0
0
1
0
1
Visit Two
Physician Decision
1
0
0
0
0
0
Visit Two
Withdrawal by Subject
1
1
1
0
1
1
Visit Two
Study Discontinued
3
2
1
7
5
6
Visit Three
Death
0
0
1
0
1
0
Visit Three
Withdrawal by Subject
0
1
1
2
0
0
Visit Three
Study Discontinued
7
6
7
7
7
6

Baseline Characteristics

Study of Fentanyl-Propofol-EMLA of L.M.X4 Technique for Bone Marrow Aspiration

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fentanyl 0.5/Placebo/Fentanyl 1
n=30 Participants
Fentanyl 0.5/Fentanyl 1/Placebo
n=28 Participants
Placebo/Fentanyl 0.5/Fentanyl 1
n=25 Participants
Placebo/Fentanyl 1/Fentanyl 0.5
n=26 Participants
Fentanyl 1/Fentanyl 0.5/Placebo
n=25 Participants
Fentanyl 1/Placebo/Fentanyl 0.5
n=28 Participants
Total
n=162 Participants
Total of all reporting groups
Age, Continuous
6.4 years
STANDARD_DEVIATION 4.3 • n=99 Participants
7.2 years
STANDARD_DEVIATION 4.5 • n=107 Participants
7.6 years
STANDARD_DEVIATION 4.8 • n=206 Participants
7.1 years
STANDARD_DEVIATION 4.1 • n=7 Participants
7.3 years
STANDARD_DEVIATION 4.7 • n=31 Participants
7.1 years
STANDARD_DEVIATION 4.4 • n=30 Participants
7.1 years
STANDARD_DEVIATION 4.4 • n=3 Participants
Sex: Female, Male
Female
15 Participants
n=99 Participants
11 Participants
n=107 Participants
12 Participants
n=206 Participants
10 Participants
n=7 Participants
9 Participants
n=31 Participants
13 Participants
n=30 Participants
70 Participants
n=3 Participants
Sex: Female, Male
Male
15 Participants
n=99 Participants
17 Participants
n=107 Participants
13 Participants
n=206 Participants
16 Participants
n=7 Participants
16 Participants
n=31 Participants
15 Participants
n=30 Participants
92 Participants
n=3 Participants

PRIMARY outcome

Timeframe: The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Population: Participants in this analysis are a subset of the 162 participants randomized since not all completed 3 visits on study. If a participant completed at least Visit 2 and received each of the 2 treatments compared they are included. Treatment on each visit was randomized; therefore these numbers cannot be derived directly from the participant flow.

During the sedation recovery period, pain was measured by one of three validated pediatric scales. Scales were applied according to the developmental ability of the participant: Numerical Pain Scale, FACES pain scale, and FLACC pain scale (a score based on behaviors observed: face, legs, activity, cry, and consolability). All three scales are scored from 0 - 10 units on a scale, and are interchangeable for comparison purposes. Any score \>0 was coded "pain", and score of 0 was coded "no pain", yielding one score for each participant's procedure.

Outcome measures

Outcome measures
Measure
Fentanyl 1mcg/kg vs Placebo
n=71 Participants
Patients who completed treatment with Fentanyl 1 mcg/kg and placebo.
Fentanyl 0.5mcg/kg vs Placebo
n=79 Participants
Patients who completed treatment with Fentanyl 0.5 mcg/kg and placebo.
Placebo
Due to study termination, not all Participants completed three planned visits. Participants who completed at least one treatment with Placebo are included in this arm. Participants were included regardless of whether they received other treatments.
Pain(Yes/No)
Pain with Fentanyl and pain with Placebo
0 Participants
6 Participants
Pain(Yes/No)
Pain with Fentanyl and no-pain with Placebo
7 Participants
8 Participants
Pain(Yes/No)
No-pain with Fentanyl pain with Placebo
10 Participants
5 Participants
Pain(Yes/No)
No-pain with Fentanyl no-pain with Placebo
54 Participants
60 Participants

PRIMARY outcome

Timeframe: The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Population: Participants in this analysis are a subset of the 162 participants randomized since not all completed 3 visits on study. If a participant completed at least Visit 2 and received each of the 2 treatments compared they are included. Treatment on each visit was randomized; therefore these numbers cannot be derived directly from the participant flow.

During the sedation recovery period, pain was measured by one of three validated pediatric scales. Scales were applied according to the developmental ability of the participant: Numerical Pain Scale, FACES pain scale, and FLACC pain scale (a score based on behaviors observed: face, legs, activity, cry, and consolability). All three scales are scored from 0 - 10 units on a scale, and are interchangeable for comparison purposes. Any score \>0 was coded "pain", and score of 0 was coded "no pain", yielding one score for each participant's procedure.

Outcome measures

Outcome measures
Measure
Fentanyl 1mcg/kg vs Placebo
n=74 Participants
Patients who completed treatment with Fentanyl 1 mcg/kg and placebo.
Fentanyl 0.5mcg/kg vs Placebo
Patients who completed treatment with Fentanyl 0.5 mcg/kg and placebo.
Placebo
Due to study termination, not all Participants completed three planned visits. Participants who completed at least one treatment with Placebo are included in this arm. Participants were included regardless of whether they received other treatments.
Pain (Yes/No)
Pain on Fentanyl (1), Pain on Fentanyl (0.5)
2 Participants
Pain (Yes/No)
Pain on Fentanyl (1) No-pain on Fentanyl (0.5)
3 Participants
Pain (Yes/No)
No-Pain on Fentanyl (1), Pain on Fentanyl (0.5)
5 Participants
Pain (Yes/No)
No-Pain on Fentanyl (1), No-Pain on Fentanyl (0.5)
64 Participants

SECONDARY outcome

Timeframe: The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Population: Due to study termination, not all Participants completed three planned visits. 107 of the 162 participants enrolled on study received treatment with Fentanyl 0.5 mcg/kg. 104 of the 162 participants enrolled on study received treatment with Fentanyl 1mcg/kg. 105 of the 162 participants enrolled on study received treatment with Placebo.

Measurements of 20% change in Heart Rate (yes/no) taken during recovery after surgery.

Outcome measures

Outcome measures
Measure
Fentanyl 1mcg/kg vs Placebo
n=107 Participants
Patients who completed treatment with Fentanyl 1 mcg/kg and placebo.
Fentanyl 0.5mcg/kg vs Placebo
n=104 Participants
Patients who completed treatment with Fentanyl 0.5 mcg/kg and placebo.
Placebo
n=105 Participants
Due to study termination, not all Participants completed three planned visits. Participants who completed at least one treatment with Placebo are included in this arm. Participants were included regardless of whether they received other treatments.
20% or Greater Change in Heart Rate
Yes
7 Participants
6 Participants
8 Participants
20% or Greater Change in Heart Rate
No
100 Participants
98 Participants
97 Participants

SECONDARY outcome

Timeframe: The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Population: Due to study termination, not all Participants completed three planned visits. 107 of the 162 participants enrolled on study received treatment with Fentanyl 0.5 mcg/kg. 104 of the 162 participants enrolled on study received treatment with Fentanyl 1mcg/kg. 105 of the 162 participants enrolled on study received treatment with Placebo.

Measurements of 20% change in respiratory rate(yes/no) taken during recovery after surgery.

Outcome measures

Outcome measures
Measure
Fentanyl 1mcg/kg vs Placebo
n=107 Participants
Patients who completed treatment with Fentanyl 1 mcg/kg and placebo.
Fentanyl 0.5mcg/kg vs Placebo
n=104 Participants
Patients who completed treatment with Fentanyl 0.5 mcg/kg and placebo.
Placebo
n=105 Participants
Due to study termination, not all Participants completed three planned visits. Participants who completed at least one treatment with Placebo are included in this arm. Participants were included regardless of whether they received other treatments.
20% or Greater Change in Respiratory Rate
Yes
21 Participants
20 Participants
24 Participants
20% or Greater Change in Respiratory Rate
No
86 Participants
84 Participants
81 Participants

SECONDARY outcome

Timeframe: The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Population: Due to study termination, not all participants completed three planned visits. 107 of the 162 participants enrolled on study received treatment with Fentanyl 0.5 mcg/kg. 104 of the 162 participants enrolled on study received treatment with Fentanyl 1mcg/kg. 105 of the 162 participants enrolled on study received treatment with Placebo.

Measurements of 20% change in blood pressure(yes/no) taken during recovery after surgery.

Outcome measures

Outcome measures
Measure
Fentanyl 1mcg/kg vs Placebo
n=107 Participants
Patients who completed treatment with Fentanyl 1 mcg/kg and placebo.
Fentanyl 0.5mcg/kg vs Placebo
n=104 Participants
Patients who completed treatment with Fentanyl 0.5 mcg/kg and placebo.
Placebo
n=105 Participants
Due to study termination, not all Participants completed three planned visits. Participants who completed at least one treatment with Placebo are included in this arm. Participants were included regardless of whether they received other treatments.
20% or Greater Change in Blood Pressure
Yes
12 Participants
10 Participants
14 Participants
20% or Greater Change in Blood Pressure
No
95 Participants
94 Participants
91 Participants

SECONDARY outcome

Timeframe: The participant was monitored from the end of the procedure until sedation recovery, which lasted a maximum of 65 min. Discharge from the recovery area was determined by hospital standards of care.

Population: Due to study termination, not all participants completed three planned visits. 107 of the 162 participants enrolled on study received treatment with Fentanyl 0.5 mcg/kg. 104 of the 162 participants enrolled on study received treatment with Fentanyl 1mcg/kg. 105 of the 162 participants enrolled on study received treatment with Placebo.

Movement (yes/no) measured during recovery after surgery.

Outcome measures

Outcome measures
Measure
Fentanyl 1mcg/kg vs Placebo
n=107 Participants
Patients who completed treatment with Fentanyl 1 mcg/kg and placebo.
Fentanyl 0.5mcg/kg vs Placebo
n=104 Participants
Patients who completed treatment with Fentanyl 0.5 mcg/kg and placebo.
Placebo
n=105 Participants
Due to study termination, not all Participants completed three planned visits. Participants who completed at least one treatment with Placebo are included in this arm. Participants were included regardless of whether they received other treatments.
Movement
Yes
57 Participants
45 Participants
58 Participants
Movement
No
50 Participants
59 Participants
47 Participants

Adverse Events

Fentanyl 0.5mcg/kg

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Fentanyl 1mcg/kg

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Doralina Anghelescu, MD

St. Jude Children's Research Hospital

Phone: 866-278-5833

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place