Pain Control Alternatives in Pediatric Patients With Distal Radius Fractures

NCT ID: NCT07120763

Last Updated: 2025-10-10

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-22

Study Completion Date

2027-08-22

Brief Summary

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The aim of this study is to evaluate the efficacy of a hematoma block and minimal ketamine pain control or hematoma block and intranasal fentanyl in pediatric patients presenting with distal radius fractures requiring reduction, compared to control of standard full conscious sedation using ketamine.

Detailed Description

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Conditions

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Distal Radius Fracture Reduction Pain Control Pediatric Fractures

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Full ketamine sedation

Including group of patients treated with full ketamine sedation in setting of distal radius fracture reduction

Group Type ACTIVE_COMPARATOR

Ketamine group

Intervention Type DRUG

Including comparisons between patients randomized for treatment with full ketamine sedation in setting of distal radius fracture reduction, hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction, or intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

Hematoma block/minimal ketamine pain control

Including group of patients treated with hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction in pediatric patients requiring reduction

Group Type ACTIVE_COMPARATOR

Ketamine + Lidocaine

Intervention Type DRUG

Including comparisons between patients randomized for treatment with full ketamine sedation in setting of distal radius fracture reduction, hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction, or intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

hematoma block/intranasal fentanyl

Including control group of patients treated with intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

Group Type ACTIVE_COMPARATOR

Fentanyl (Nasalfent, Fentanyl Citrate Nasal Spray)

Intervention Type DRUG

Including comparisons between patients randomized for treatment with full ketamine sedation in setting of distal radius fracture reduction, hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction, or intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

Interventions

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Ketamine + Lidocaine

Including comparisons between patients randomized for treatment with full ketamine sedation in setting of distal radius fracture reduction, hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction, or intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

Intervention Type DRUG

Ketamine group

Including comparisons between patients randomized for treatment with full ketamine sedation in setting of distal radius fracture reduction, hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction, or intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

Intervention Type DRUG

Fentanyl (Nasalfent, Fentanyl Citrate Nasal Spray)

Including comparisons between patients randomized for treatment with full ketamine sedation in setting of distal radius fracture reduction, hematoma block/minimal ketamine pain control (. 0.25mg/kg) for distal radius fracture reduction, or intranasal fentanyl and hematoma block, utilized in the setting of distal radius fractures in pediatric patients requiring reduction

Intervention Type DRUG

Other Intervention Names

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fentanyl + lidocaine

Eligibility Criteria

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Inclusion Criteria

* Children requiring reduction for distal radius fracture
* Children presenting to the emergency department
* Children who are ages 3 to 17 years.

Exclusion Criteria

* Pediatric patients \<3 years old
* Adult patients (i.e. ages 18 or up)
* Pediatric patients with injury patterns that are not amenable to hematoma block.
* Children who are not a candidate for sedation related to BMI \> 95%tile for age, ASA class \> 2, Mallampati score \> 2, and pregnant patients
Minimum Eligible Age

3 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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State University of New York at Buffalo

OTHER

Sponsor Role lead

Responsible Party

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Tara Petroski

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Oshei Children's Hospital

Buffalo, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Dr. Ellen Lutnick Lutnick, MD

Role: CONTACT

(716) 323-2100

Facility Contacts

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Dr. Tara Petroski Emergency Medicine Physician, MD

Role: primary

716-323-2100

References

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McCarty EC, Mencio GA, Walker LA, Green NE. Ketamine sedation for the reduction of children's fractures in the emergency department. J Bone Joint Surg Am. 2000 Jul;82-A(7):912-8. doi: 10.2106/00004623-200007000-00002.

Reference Type BACKGROUND
PMID: 10901305 (View on PubMed)

Disel NR, Yilmaz HL, Sertdemir Y, Yesilagac H, Avci A. Etomidate Versus Ketamine: Effective Use in Emergency Procedural Sedation for Pediatric Orthopedic Injuries. Pediatr Emerg Care. 2016 Dec;32(12):830-834. doi: 10.1097/PEC.0000000000000373.

Reference Type BACKGROUND
PMID: 25834964 (View on PubMed)

Jordan RW, Aquilina A, Westacott DJ, Cooke S. A comparison of ketamine sedation and general anaesthesia for manipulation of paediatric forearm fractures. Acta Orthop Belg. 2016 Dec;82(4):836-842.

Reference Type BACKGROUND
PMID: 29182126 (View on PubMed)

Morrison T, Carender C, Kilbane B, Liu RW. Procedural Sedation With Ketamine Versus Propofol for Closed Reduction of Pediatric Both Bone Forearm Fractures. Orthopedics. 2017 Sep 1;40(5):288-294. doi: 10.3928/01477447-20170824-01. Epub 2017 Sep 7.

Reference Type BACKGROUND
PMID: 28877328 (View on PubMed)

Kwong A, Aldridge ES, Jayawardana R, Brookwick A, Miller J, Buntine PG. Length of stay outcomes in patients receiving ketamine sedation versus Bier's block anaesthesia for procedural closed fracture reduction: A retrospective audit of paediatric emergency department patients. Emerg Med Australas. 2022 Feb;34(1):73-77. doi: 10.1111/1742-6723.13844. Epub 2021 Aug 29.

Reference Type BACKGROUND
PMID: 34459117 (View on PubMed)

Other Identifiers

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STUDY00009073

Identifier Type: -

Identifier Source: org_study_id

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