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Intramuscular Ketorolac Versus Oral Ibuprofen for Pain Relief in First Trimester Suction Curettage

This study has been completed.
Sponsor:
Collaborator:
Society of Family Planning
Information provided by (Responsible Party):
Planned Parenthood League of Massachusetts
ClinicalTrials.gov Identifier:
NCT01595282
First received: May 19, 2011
Last updated: December 12, 2012
Last verified: December 2012
History of Changes
  Purpose

The aim of this study is to compare the effect of pre-procedural ketorolac to ibuprofen on immediate post-procedural pain scores in patients undergoing first trimester suction curettage with local anesthesia only.

Our primary hypothesis is that IM ketorolac compared to oral ibuprofen will result in an approximate 30% reduction in pain scores on a 21-point numerical rating scale immediately after the procedure.

Secondary hypotheses include:

  • Pain scores on the 21-point scale will also be significantly lower in the ketorolac group immediately after cervical dilation and 15 minutes post-procedure.
  • Fewer patients in the ketorolac group will rate their pain as "severe" on a subjective pain rating scale.
  • Patients in the ketorolac group will be more satisfied with their pain control.
  • Side effects will be similar between groups.

Condition Intervention
Pain
 Drug: Ketorolac
Drug: Ibuprofen

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Intramuscular Ketorolac Versus Oral Ibuprofen for Pain Relief in First Trimester Suction Curettage: a Randomized Clinical Trial.

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by Planned Parenthood League of Massachusetts:

Primary Outcome Measures:
  • Immediate post-procedure pain score [ Time Frame: Immediately (within 1 minute) after suction and speculum removal ] [ Designated as safety issue: No ]
    The primary endpoint is subjects' immediate post-procedure pain score on a 21-point 0 to 100 scale (in increments of five). This scale has been previously validated and used for research purposes, including for pain research evaluating suction curettage elsewhere and at our institution (Jensen 1986, Williamson 2004, Allen 2009).


Secondary Outcome Measures:
  • Pain scores immediately after cervical dilation [ Time Frame: Immediately (within 1 minute) after cervical dilation prior to the introduction of the suction cannula ] [ Designated as safety issue: No ]
    21-point 0 to 100 scale (in increments of five)

  • Pain scores 15 minutes post-procedure [ Time Frame: Fifteen minutes after the procedure ] [ Designated as safety issue: No ]
    21-point 0 to 100 scale (in increments of five)

  • Change in Subjective pain score [ Time Frame: immediately after cervical dilation, immediately after the procedure, and 15 minutes after the procedure ] [ Designated as safety issue: No ]
    We will measure pain on a subjective scale of "no pain, mild pain, moderate pain or severe pain."


Enrollment: 94
Study Start Date: June 2011
Study Completion Date: June 2012
Primary Completion Date: June 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Ketorolac
Intramuscular injection of ketorolac 60 mg in 2cc -plus- placebo tablet (calcium carbonate 600 mg tablet). For subjects who are 50 kg or less, intramuscular injection of ketorolac 30 mg in 1cc -plus- placebo tablet (calcium carbonate 600 mg tablet)
 Drug: Ketorolac
For subjects weighing over 50 kg, ketorolac 60 mg in 2cc administered via intramuscular injection 30-60 minutes before suction curettage procedure. For subjects weighing 50 kg or less, ketorolac 30 mg in 1 cc administered via intramuscular injection 30-60 minutes before suction curettage procedure
Other Name: Toradol
Active Comparator: Ibuprofen
Ibuprofen 800 mg tablet -plus- intramuscular injection of 2cc saline placebo. For subjects weighing 50 kg or less, ibuprofen 600 mg tablet -plus- intramuscular injection of 2cc saline placebo
 Drug: Ibuprofen
For subjects weighing over 50 kg, ibuprofen 800 mg tablet administered orally 60-90 minutes before suction curettage procedure. For subjects weighing 50 kg or less, ibuprofen 600 mg tablet administered orally 60-90 minutes before suction curettage procedure.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Women age 18 or older seeking suction curettage at Planned Parenthood League of Massachusetts (PPLM)
  • Gestational age less than or equal to 11+6, confirmed by ultrasound
  • Eligible for suction curettage according to PPLM protocols
  • Choice of local anesthesia

Exclusion Criteria:

  • Choice of IV sedation for pain control
  • Hypersensitivity to NSAIDs or lidocaine
  • Contraindications to NSAIDs:

Active renal disease Active hepatic disease Gastric ulcer disease or gastritis Long-term NSAID or aspirin use Bleeding disorder

  • NSAIDs taken < 8 hours prior to procedure
  • Need for cervical ripening with either misoprostol or mechanical priming agent (laminaria/Dilapan)
  • Long-term narcotic use
  • Unable or unwilling to complete required study procedures
  • Previous participation in the study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01595282

Locations
United States, Massachusetts
Planned Parenthood League of Massachusetts
Boston, Massachusetts, United States, 02215
Sponsors and Collaborators
Planned Parenthood League of Massachusetts
Society of Family Planning
Investigators
Principal Investigator: Principal Investigator, MD, MPH Planned Parenthood League of Massachusetts
  More Information

No publications provided

Responsible Party: Planned Parenthood League of Massachusetts
ClinicalTrials.gov Identifier: NCT01595282     History of Changes
Other Study ID Numbers: 2011-p-000259
Study First Received: May 19, 2011
Last Updated: December 12, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Planned Parenthood League of Massachusetts:
pain
suction curettage

Additional relevant MeSH terms:
Ibuprofen
Ketorolac
Ketorolac Tromethamine
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
 Pharmacologic Actions
Anti-Inflammatory Agents
Therapeutic Uses
Antirheumatic Agents
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Central Nervous System Agents

ClinicalTrials.gov processed this record on May 19, 2013