Pain Management in ED for Incision and Drainage of Abscess

• Status: Withdrawn
• Trial end date: 2011-12-01
• Target enrollment: 0
• Participant gender: All

Summary

Patients presenting with painful procedures in the Emergency Department (ED) have been shown to frequently have inadequate pain management. The incision and drainage (I&D) of an abscess is a common procedure that is viewed by many emergency physicians as only requiring a localized anesthetic for pain management. However, it has been documented in previous research that there can be disconnect between what emergency medicine physicians interpret as painful and what patients experience as pain. A trial will be conducted to focus on use of intramuscular (IM) Fentanyl as an intervention to help alleviate pain associated with the incision and drainage of an abscess. This is a procedure that rarely receives systemic opioids.

This double blinded protocol will randomize a total of 50 patients patients with abscesses to receive either a combination of Fentanyl IM followed by subcutaneous (SC) local bupivicaine analgesia or Normal Saline IM followed by SC local bupivicaine analgesia. Only opiate naive patients will be enrolled. The primary outcomes studied are patients overall satisfaction with procedure, and patients level of pain associated with the procedure.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: University of California, Los Angeles
• Treatments: Fentanyl

Criteria

Inclusion Criteria:

• Age >18 and < 65 years

• Presenting with a simple abscesses requiring incision and drainage

• Treating physician has to state that the patient's usual treatment would not include systemic opioids before incision and drainage.

Exclusion Criteria:

• Patients are unable to consent to procedure the procedure

• Patients are less than age 18 or older than age 65

• Patients are unable to avoid driving for 2 hours after administration of the intramuscular medication (Fentanyl or placebo)

• Patients have hypersensitivity or allergy to Fentanyl

• Patients are pregnant

• Patients have taken a narcotic pain medication in the last 14 days

• Patients have a history of drug or alcohol addiction

• Patients have taken an monoamine oxidase (MAO) inhibitor in the last 14 days (such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate)

• Patients have a breathing disorder such as chronic obstructive pulmonary disease

• Patients have a history of head injury or brain tumor

• Patients have a heart rhythm disorder

• Patients have seizures or epilepsy

• Patients have mental illness such as depression, hallucinations

• Patients have low blood pressure

• Patients have liver or kidney disease.