Does Alkalinization Reduce Perceived Pain Levels During Sentinel Lymph Node Imaging?

NCT ID: NCT01660412

Last Updated: 2017-11-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-08-01

Study Completion Date

2016-12-30

Brief Summary

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Pain during nuclear medicine breast lymphnode detection procedures has been reported as high as 8.8/10. Using Sodium Bicarbonate to alkalinize the radio-pharmaceutical injection, pain can safely be reduced from 6.6/10 to 4.7/10, during breast lymph node detection procedures.

In sites other then the breast, using Bicarbonate to make the injection's pH closer to natural, attempts to lower the pain levels will be performed.

Hypothesis: The perceived pain level during non breast sentinel lymph node techniques can be reduced by raising the pH of the injectate (Tc-99m SC) to near the physiologic level of pH 7.40.

Detailed Description

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Conditions

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Pain

Keywords

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Pain Alkalinization Technetium 99m Sulfur Colloid sentinel lymphoscintigraphy?

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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pH altered first

The first injection administered will be the pH altered solution. The second injection will be the standard of care solution (opposite order). The remaining injections will be randomly assigned as either standard of care or pH altered.

Group Type ACTIVE_COMPARATOR

ph Altered first

Intervention Type DRUG

For the first injection, Sodium Bicarbonate will be compounded with Tc-99m SC, to raise the pH up to \~7.40. For the second injection, the standard of care will be given, and randomly after that either standard of care, or pH altered will be given.

Standard of Care first

The first injection administered will be the standard of care solution (SOC). The second injection will be the pH altered solution. The remaining injections will be randomly assigned as either standard of care or pH altered.

Group Type ACTIVE_COMPARATOR

Standard of Care First

Intervention Type DRUG

For the second injection, and randomly after that, Sodium Bicarbonate will be compounded with Tc-99m SC, to raise the pH up to \~7.40.

Interventions

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Standard of Care First

For the second injection, and randomly after that, Sodium Bicarbonate will be compounded with Tc-99m SC, to raise the pH up to \~7.40.

Intervention Type DRUG

ph Altered first

For the first injection, Sodium Bicarbonate will be compounded with Tc-99m SC, to raise the pH up to \~7.40. For the second injection, the standard of care will be given, and randomly after that either standard of care, or pH altered will be given.

Intervention Type DRUG

Other Intervention Names

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Sodium Bicarbonate second Sodium Bicarbonate first

Eligibility Criteria

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Inclusion Criteria

* Patients presenting for SLN imaging for melanoma or who have had an excisional biopsy for melanoma of the thorax and appendicular structures;
* Patients scheduled to receive two or more injections of Tc-99m SC for the purpose of clinical management of melanoma or who have had an excisional biopsy for melanoma of the thorax and appendicular structures.

Exclusion Criteria

* Patients presenting for SLN imaging of lesions involving the breast, ear, nose, and genitourinary regions;
* Patients scheduled to receive only a single injection of Tc-99m SC;
* Pregnant or breast feeding women.
Minimum Eligible Age

18 Years

Maximum Eligible Age

122 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Howard J Barnhard, Resident Research Endowment.

UNKNOWN

Sponsor Role collaborator

UAMS DEPT of Radiology.

UNKNOWN

Sponsor Role collaborator

University of Arkansas

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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James A Ntambi, MD

Role: PRINCIPAL_INVESTIGATOR

UAMS

Locations

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UAMS

Little Rock, Arkansas, United States

Site Status

Countries

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United States

References

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Fetzer S, Holmes S. Relieving the pain of sentinel lymph node biopsy tracer injection. Clin J Oncol Nurs. 2008 Aug;12(4):668-70. doi: 10.1188/08.CJON.668-670.

Reference Type BACKGROUND
PMID: 18676334 (View on PubMed)

Stojadinovic A, Peoples GE, Jurgens JS, Howard RS, Schuyler B, Kwon KH, Henry LR, Shriver CD, Buckenmaier CC. Standard versus pH-adjusted and lidocaine supplemented radiocolloid for patients undergoing sentinel-lymph-node mapping and biopsy for early breast cancer (PASSION-P trial): a double-blind, randomised controlled trial. Lancet Oncol. 2009 Sep;10(9):849-54. doi: 10.1016/S1470-2045(09)70194-9. Epub 2009 Aug 5.

Reference Type BACKGROUND
PMID: 19664956 (View on PubMed)

Johnston MJ, Ntambi JA, Hilliard N, Spencer HJ, Vaughn R, Owens SS, Myrick RS, Parker LD, Garner DA, Yarbrough TL. Reducing perceived pain levels during nonbreast lymphoscintigraphy. Clin Nucl Med. 2015 Dec;40(12):945-9. doi: 10.1097/RLU.0000000000000905.

Reference Type RESULT
PMID: 26222533 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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31337

Identifier Type: -

Identifier Source: org_study_id