A Randomized, Double-Masked, Controlled, Single Site Investigator Initiated, Exploratory Study of the Midazolam/Ketamine Melt vs Ketamine Melt Alone vs Midazolam Melt Alone in Subjects Undergoing Intraocular Surgery.

NCT ID: NCT04725747

Last Updated: 2021-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-25

Study Completion Date

2021-06-30

Brief Summary

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This study is designed to explore the sedative and analgesic effectiveness of the Midazolam/Ketamine melt compared to Midazolam melt alone or Ketamine melt alone in subjects undergoing intraocular surgery.

Detailed Description

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Cataract surgery today is a highly effective and efficient procedure, with average times for completion ranging around 15 minutes in duration. Patients undergoing cataract surgery are typically given sedatives and often times pain medication (e.g. opioids) just prior to and during the procedure. The overwhelming majority of patients are given these medications via intravenous administration. The insertion of an IV line has been associated with patient complaints of pain and bruising, and can increase the administrative burden on the clinical staff. In addition to the national crisis surrounding opioid abuse, opioids have many negative side effects during cataract surgery such as respiratory depression, dizziness, nausea, and post- operative vomiting.

To reduce the side effects, improve patient satisfaction, and help surgical center flow the Midazolam/Ketamine melt (MK Melt) has been suggested as an alternative to provide sedation and analgesia in subjects undergoing minor outpatient surgery, such as cataract surgery. The addition of ketamine should provide enough analgesia for the mild discomfort reported during cataract surgery. This study is intended to evaluate the MK Melt and its ability to provide an adequate level of both sedation and intraoperative pain control vs an active control.

Conditions

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Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

1:1:1 treatment arms. Arm 1 Ketamine/Midazolam melt. Arm 2 Ketamine melt. Arm 3 Midazolam melt.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
This is a double masked study in which the doctor/nurse anesthetist evaluating the subject with the Ramsey scale will be masked to the treatment given. The subject will also be masked to the treatment group and the study/control drug.

To keep the doctor/nurse anesthetist masked, the unmasked nurse will prepare the study/control drug and then administer it to the subject without unmasking the doctor/nurse anesthetist or the subject. The unmasked nurse will administer one 3/50mg MK melt, or one 3mg Midazolam melt, or one 50mg Ketamine melt sublingually based on the subject's randomization assignment.

Study Groups

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Midazolam/Ketamine Melt

One Midazolam/Ketamine 3mg/50mg melt administered sublingually

Group Type EXPERIMENTAL

Midazolam/Ketamine HCl 3mg-50mg sublingual

Intervention Type DRUG

Single sublingual administration of Midazolam/Ketamine HCl 3mg-50mg sublingually prior to surgery

Midazolam Melt

Midazolam 3mg melt administered sublingually

Group Type ACTIVE_COMPARATOR

Midazolam 3mg Sublingual

Intervention Type DRUG

Single sublingual administration of Midazolam 3mg sublingually prior to surgery

Ketamine Melt

Ketamine 50mg melt administered sublingually

Group Type ACTIVE_COMPARATOR

Ketamine 50mg Sublingual

Intervention Type DRUG

Single sublingual administration of Ketamine HCl 50mg sublingually prior to surgery

Interventions

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Midazolam/Ketamine HCl 3mg-50mg sublingual

Single sublingual administration of Midazolam/Ketamine HCl 3mg-50mg sublingually prior to surgery

Intervention Type DRUG

Midazolam 3mg Sublingual

Single sublingual administration of Midazolam 3mg sublingually prior to surgery

Intervention Type DRUG

Ketamine 50mg Sublingual

Single sublingual administration of Ketamine HCl 50mg sublingually prior to surgery

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Subjects must be male or female, and between the ages of 55-80 years old.
2. Subjects willing and able to sign the informed consent and capable of committing to the duration of the study.
3. Subjects undergoing uncomplicated stand-alone cataract surgery without planned use of Omidria or intra-operative lidocaine.
4. Subjects that are willing to have an IV placed prior to intraocular surgery
5. Subjects undergoing first eye cataract surgery
6. Subjects that in the opinion of the investigator can tolerate 1 dose of MK 3/50 Melt.

Exclusion Criteria

1. Subjects who have undergone sedation in the past 90 days.
2. Women who are pregnant or lactating at the time of the study.
3. Subjects who do not wish to or cannot comply with study procedures.
4. Subject with any cognitive impairment (i.e: Alzheimer's, dementia, etc.) that in the opinion of the investigator may confound the study results.
5. Subjects with history of substance abuse.
6. Subjects that are currently taking a prescription pain medication.
7. Subjects that are not willing to abstain from all over-the-counter pain medication with the exception of 500-1000mg acetaminophen for 24 hours prior to surgery.
8. Subjects that are not willing to abstain from NSAID or steroid eye drops prior to surgery.
9. Subjects with planned use of femtosecond laser, zepto, iris hooks or a malyugin ring during cataract surgery.
10. Subjects with chronic pain rated moderate to severe within the past week.
11. Subjects that have a psychiatric disorder that is currently uncontrolled.
12. Subjects scheduled for same day bilateral or second eye cataract surgery.
Minimum Eligible Age

55 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vance Thompson Vision

OTHER

Sponsor Role lead

Responsible Party

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John Berdahl, MD

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Vance Thompson Vision

Sioux Falls, South Dakota, United States

Site Status

Countries

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United States

Other Identifiers

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MAKER

Identifier Type: -

Identifier Source: org_study_id

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