Intravenous Fluid for Pediatric Migraine in the Emergency Department (EDMigraine3)
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Purpose
The purpose of this study is to evaluate the effect of intravenous fluid (0.9% sodium chloride and water) alone on headache pain in children with migraine visiting the Emergency Department.
| Condition | Intervention | Phase |
|---|---|---|
|
Migraine Headache |
Drug: Normal saline |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Single-blind, Placebo-challenge Study of Intravenous Fluid Hydration in the Management of Pediatric Migraine in the Emergency Department |
- Headache pain [ Time Frame: 30 minutes ] [ Designated as safety issue: Yes ]Pain will be assessed using three measures: (1) Nine Faces Pain scale; (2) Visual Analogue Scale; and (3) Four categories (none, mild, moderate, or severe)
- Nausea [ Time Frame: 30 minutes ] [ Designated as safety issue: Yes ]Severity will be assessed using: (1) Visual Analogue Scale; (2) Four categories (none, mild, moderate, severe)
- Vomiting [ Time Frame: 30 minutes ] [ Designated as safety issue: No ]
- Use of rescue medication [ Time Frame: 24 hours ] [ Designated as safety issue: No ]Use of any rescue medication after leaving the Emergency Department
- Headache recurrence [ Time Frame: 24 hours ] [ Designated as safety issue: No ]Recurrence or worsening of headache after leaving the Emergency Department
- Return to Emergency Department [ Time Frame: 24 hours ] [ Designated as safety issue: No ]Return to Emergency Department for treatment of migraine within 24 hours
| Estimated Enrollment: | 60 |
| Study Start Date: | March 2010 |
| Estimated Study Completion Date: | July 2012 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Normal saline |
Drug: Normal saline
10 ml/kg of normal saline will be administered over 30 minutes
Other Name: 0.9% sodium chloride and water
|
| Experimental: Normal saline and possible medication |
Drug: Normal saline
10 ml/kg of normal saline will be administered over 30 minutes
Other Name: 0.9% sodium chloride and water
|
Detailed Description:
Migraine is a common and disabling disorder for children. The pain may be severe and relatively few effective medications are approved for use in children. The Emergency Department (ED) remains an important resource for children suffering from migraine whom have not responded to their usual therapy. While a number of effective intravenous therapies have been studied in adults, there has been only one such study in children. As such, emergency physicians have little or no information about the safety and efficacy of these medications in children. However, the conduct of clinical trials where pain is the outcome measure is often limited by a high placebo-response rate. The expectation of treatment can significantly alter the response to medications especially when pain severity is the outcome measure. Moreover, the investigators have found that intravenous fluid alone may help to treat migraine headache in children. The investigators propose a study to examine the response to intravenous fluid hydration as initial therapy comparing a group with expectation of medication and another group without the initial expectation of medication. The results of the study will help to estimate the rate of response to intravenous fluid and to evaluate the placebo-effect (i.e. expectation of treatment) in studies of migraine treatment in the ED. Exposure to additional and possibly unnecessary medications will thus be minimized and the results of future trials more definitive on the effect of the study medication.
Eligibility| Ages Eligible for Study: | 5 Years to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of migraine or probable migraine (with or without aura) per the International Classification of Headache Disorders (2nd edition)
- Visiting the Emergency Department for migraine treatment
- Emergency Department physician has chosen to administer intravenous medication
- Has taken usual therapy at home or at least one does of either ibuprofen or acetaminophen in the Emergency Department
Exclusion Criteria:
- Other probable cause for headache (e.g. ventriculoperitoneal shunt, neoplasm, intracranial cyst)
- Head trauma causing loss of consciousness within 1 week of presentation
- Fever (temperature > 38.5 oC)
- Signs or symptoms of meningitis
Contacts and Locations| Contact: Lawrence P Richer, MD, MSc | 780-407-7329 | lricher@ualberta.ca |
| Contact: William Craig, MD, MSc | 780-407-3555 | William.Craig@albertahealthservices.ca |
| Canada, Alberta | |
| Stollery Children's Hospital Emergency Department | Recruiting |
| Edmonton, Alberta, Canada, T6G 2J3 | |
| Contact: Lawrence P Richer, MD, MSc 780-407-7329 lricher@ualberta.ca | |
| Contact: William Craig, MD, MSc 780-407-3555 william.craig@albertahealthservices.ca | |
| Principal Investigator: Lawrence P Richer, MD, MSc | |
| Sub-Investigator: William Craig, MD, MSc | |
| Sub-Investigator: Brian Rowe, MD, MSc | |
| Principal Investigator: | Lawrence P Richer, MD, MSc | University of Alberta |
More Information
No publications provided
| Responsible Party: | Lawrence Richer, Principal Investigator, University of Alberta |
| ClinicalTrials.gov Identifier: | NCT01073787 History of Changes |
| Other Study ID Numbers: | Pro00008034 |
| Study First Received: | February 22, 2010 |
| Last Updated: | May 2, 2012 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by University of Alberta:
|
migraine headache pediatric children Emergency Department |
Additional relevant MeSH terms:
|
Emergencies Headache Migraine Disorders Disease Attributes Pathologic Processes Pain Neurologic Manifestations |
Nervous System Diseases Signs and Symptoms Headache Disorders, Primary Headache Disorders Brain Diseases Central Nervous System Diseases |
ClinicalTrials.gov processed this record on May 22, 2013