Trial Outcomes & Findings for 2 Dose Neuraxial Morphine for Prevention of PDPH (NCT NCT02473276)

NCT ID: NCT02473276

Last Updated: 2025-02-05

Results Overview

The primary outcome will be the incidence of postdural puncture headache at 48 hours after accidental dural puncture. This will be determined by a face to face questionnaire and the severity of headache will be rated according to a verbal rating scale (0 -10).

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

44 participants

Primary outcome timeframe

48 hours after accidental dural puncture

Results posted on

2025-02-05

Participant Flow

Participant milestones

Participant milestones
Measure
EPID PFM
The group "EPID PFM" will receive 3 mg (6 ml) of preservative-free morphine, followed by 3 mL of sterile normal saline, to be administered through the epidural catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 3 mg (6 ml) of preservative-free morphine (for a total of two doses).
EPID SAL
The placebo group, "EPID NS", will receive 6 mL of sterile normal saline via the epidural catheter followed by another 3 mL sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 6 mL of sterile normal saline (for a total of two doses).
IT PFM
The group, "IT PFM" will receive 200 micrograms (mcg) (0.4 mL) of preservative-free morphine via the intrathecal catheter, followed by a flush of the catheter with 2 mL of sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 200 mcg (0.4 mL) of preservative-free morphine (for a total of two doses).
IT SAL
The placebo group IT SAL will receive 0.4 mL and then 2 mL of sterile normal saline through the intrathecal catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 0.4 mL and then 2 mL of sterile normal saline (for a total of two doses).
Overall Study
STARTED
8
10
11
15
Overall Study
COMPLETED
8
10
11
15
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

2 Dose Neuraxial Morphine for Prevention of PDPH

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
EPID PFM
n=8 Participants
The group "EPID PFM" will receive 3 mg (6 ml) of preservative-free morphine, followed by 3 mL of sterile normal saline, to be administered through the epidural catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 3 mg (6 ml) of preservative-free morphine (for a total of two doses).
EPID SAL
n=10 Participants
The placebo group, "EPID NS", will receive 6 mL of sterile normal saline via the epidural catheter followed by another 3 mL sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 6 mL of sterile normal saline (for a total of two doses).
IT PFM
n=11 Participants
The group, "IT PFM" will receive 200 micrograms (mcg) (0.4 mL) of preservative-free morphine via the intrathecal catheter, followed by a flush of the catheter with 2 mL of sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 200 mcg (0.4 mL) of preservative-free morphine (for a total of two doses).
IT SAL
n=15 Participants
The placebo group IT SAL will receive 0.4 mL and then 2 mL of sterile normal saline through the intrathecal catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 0.4 mL and then 2 mL of sterile normal saline (for a total of two doses).
Total
n=44 Participants
Total of all reporting groups
Age, Continuous
32.9 years
STANDARD_DEVIATION 2.6 • n=5 Participants
31 years
STANDARD_DEVIATION 5.5 • n=7 Participants
31.1 years
STANDARD_DEVIATION 5.8 • n=5 Participants
32.9 years
STANDARD_DEVIATION 6.3 • n=4 Participants
32.1 years
STANDARD_DEVIATION 5.4 • n=21 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
10 Participants
n=7 Participants
11 Participants
n=5 Participants
15 Participants
n=4 Participants
44 Participants
n=21 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
3 Participants
n=7 Participants
8 Participants
n=5 Participants
7 Participants
n=4 Participants
18 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
8 Participants
n=5 Participants
6 Participants
n=7 Participants
3 Participants
n=5 Participants
7 Participants
n=4 Participants
24 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
2 Participants
n=21 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
0 Participants
n=4 Participants
3 Participants
n=21 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
5 Participants
n=4 Participants
9 Participants
n=21 Participants
Race (NIH/OMB)
White
6 Participants
n=5 Participants
7 Participants
n=7 Participants
4 Participants
n=5 Participants
8 Participants
n=4 Participants
25 Participants
n=21 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
2 Participants
n=4 Participants
7 Participants
n=21 Participants
Region of Enrollment
United States
8 participants
n=5 Participants
10 participants
n=7 Participants
11 participants
n=5 Participants
15 participants
n=4 Participants
44 participants
n=21 Participants

PRIMARY outcome

Timeframe: 48 hours after accidental dural puncture

The primary outcome will be the incidence of postdural puncture headache at 48 hours after accidental dural puncture. This will be determined by a face to face questionnaire and the severity of headache will be rated according to a verbal rating scale (0 -10).

Outcome measures

Outcome measures
Measure
EPID PFM
n=8 Participants
The group "EPID PFM" will receive 3 mg (6 ml) of preservative-free morphine, followed by 3 mL of sterile normal saline, to be administered through the epidural catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 3 mg (6 ml) of preservative-free morphine (for a total of two doses).
EPID SAL
n=10 Participants
The placebo group, "EPID NS", will receive 6 mL of sterile normal saline via the epidural catheter followed by another 3 mL sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 6 mL of sterile normal saline (for a total of two doses).
IT PFM
n=11 Participants
The group, "IT PFM" will receive 200 micrograms (mcg) (0.4 mL) of preservative-free morphine via the intrathecal catheter, followed by a flush of the catheter with 2 mL of sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 200 mcg (0.4 mL) of preservative-free morphine (for a total of two doses).
IT SAL
n=15 Participants
The placebo group IT SAL will receive 0.4 mL and then 2 mL of sterile normal saline through the intrathecal catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 0.4 mL and then 2 mL of sterile normal saline (for a total of two doses).
Number of Participants With Postdural Puncture Headache
3 Participants
4 Participants
8 Participants
10 Participants

SECONDARY outcome

Timeframe: 48 hours after accidental dural puncture

A secondary outcome will be the need for epidural blood patch at 48 hours after accidental dural puncture. This will be recorded on the study data collection sheet.

Outcome measures

Outcome measures
Measure
EPID PFM
n=8 Participants
The group "EPID PFM" will receive 3 mg (6 ml) of preservative-free morphine, followed by 3 mL of sterile normal saline, to be administered through the epidural catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 3 mg (6 ml) of preservative-free morphine (for a total of two doses).
EPID SAL
n=10 Participants
The placebo group, "EPID NS", will receive 6 mL of sterile normal saline via the epidural catheter followed by another 3 mL sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 6 mL of sterile normal saline (for a total of two doses).
IT PFM
n=11 Participants
The group, "IT PFM" will receive 200 micrograms (mcg) (0.4 mL) of preservative-free morphine via the intrathecal catheter, followed by a flush of the catheter with 2 mL of sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 200 mcg (0.4 mL) of preservative-free morphine (for a total of two doses).
IT SAL
n=15 Participants
The placebo group IT SAL will receive 0.4 mL and then 2 mL of sterile normal saline through the intrathecal catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 0.4 mL and then 2 mL of sterile normal saline (for a total of two doses).
Number of Participants in Need for Epidural Blood Patch
2 Participants
2 Participants
5 Participants
7 Participants

Adverse Events

EPID PFM

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

EPID SAL

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

IT PFM

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

IT SAL

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
EPID PFM
n=8 participants at risk
The group "EPID PFM" will receive 3 mg (6 ml) of preservative-free morphine, followed by 3 mL of sterile normal saline, to be administered through the epidural catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 3 mg (6 ml) of preservative-free morphine (for a total of two doses).
EPID SAL
n=10 participants at risk
The placebo group, "EPID NS", will receive 6 mL of sterile normal saline via the epidural catheter followed by another 3 mL sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 6 mL of sterile normal saline (for a total of two doses).
IT PFM
n=11 participants at risk
The group, "IT PFM" will receive 200 micrograms (mcg) (0.4 mL) of preservative-free morphine via the intrathecal catheter, followed by a flush of the catheter with 2 mL of sterile normal saline. 16 to 24 hours after receiving the first dose, the patient will then receive 200 mcg (0.4 mL) of preservative-free morphine (for a total of two doses).
IT SAL
n=15 participants at risk
The placebo group IT SAL will receive 0.4 mL and then 2 mL of sterile normal saline through the intrathecal catheter. 16 to 24 hours after receiving the first dose, the patient will then receive 0.4 mL and then 2 mL of sterile normal saline (for a total of two doses).
Pregnancy, puerperium and perinatal conditions
Postdural Puncture Headache
37.5%
3/8 • 48 hours after accidental dural puncture
40.0%
4/10 • 48 hours after accidental dural puncture
72.7%
8/11 • 48 hours after accidental dural puncture
66.7%
10/15 • 48 hours after accidental dural puncture

Additional Information

Richard Smiley

Columbia University

Phone: 212 305 5006

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place