Intranasal Dexmedetomidine for Procedural Pain Management in Elderly Adults in Palliative Care
Status:
Terminated
Trial end date:
2021-06-08
Target enrollment:
Participant gender:
Summary
Dexmedetomidine is allowed in Switzerland for intravenous (IV) medication in the intensive
care unit in the adult patient. Its active molecule, Dexmedetomidine (Dex), is a selective
and powerful α2-Adrenoreceptors (AR) agonist that shows the following complementary
properties: anxiolytic, sedative and analgesic. Moreover, it displays interesting
cardiovascular, respiratory and neuropsychic safety and tolerance profiles.
There is increasing number of promising studies for the use of intranasal (IN) Dex in
pediatric sedation due to its non-invasive nature, its efficiency and its rare secondary
effects. However, there is currently no information in the literature on the use of IN Dex in
elderly multi-medicated patients in palliative care.
In this end-of-life population, pain is controlled with administration of opioids.
Procedures, such as nursing cares, can generate pain and anxiety to the patient. Preventive
analgesia, subcutaneous (SC) opioids, is administered before the care. However, most of the
time, this additional dose fails to relieve the patient from his pain. In SPdol observational
study, 42% daily hygiene and comfort nursing care remained painful despite the administration
of a preventive analgesia.
IN Dex seems to be a good candidate for non-invasive analgesia and sedation in patients
admitted in palliative care before the nursing procedure.
In this study, the investigators compare the efficiency of IN Dex to the regular extradose of
SC opioids for analgesia before daily nursing care on elderly patients in the palliative care
unit.
The study design is a cross over, two-sided, superiority, double-blind, placebo-controlled
and randomized clinical trial.