E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Joint dislocation ; Limb displaced fracture |
Traumatisme de membre avec fracture ou luxation d’articulation |
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E.1.1.1 | Medical condition in easily understood language |
Joint dislocation ; Limb displaced fracture |
Traumatisme de membre avec fracture ou luxation d’articulation |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10075886 |
E.1.2 | Term | Limb fractures and dislocations |
E.1.2 | System Organ Class | 100000004863 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Determine the brain concentrations necessary to reach the optimal sedation in patients with indications of very painful orthopedic emergency procedures |
déterminer les concentrations cérébrales de propofol nécessaires à l’obtention d’une sédation optimale, pour des soins très douloureux tels qu’une réduction de fracture déplacée ou de luxation d’articulation. |
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E.2.2 | Secondary objectives of the trial |
Delays, lengths and levels of sedation obtained, overall delivered doses of propofol, nature, appearance delays and lengths of potential adverse events (AE), particularly complications related to procedural sedation, and necessary interventions to handle these AE, will be studied as secondary objectives |
délais, durées et niveaux de sédation obtenus ; doses totales de propofol administrées ; nature, délai d’apparition et durée des éventuels effets indésirables (EI) ; interventions nécessaires à la prise en charge de ces EI |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Age of 18 or more • Affiliated or beneficiary of a French health insurance system • Indication of procedural sedation by the emergency department physician in the context of the management of a patient with an orthopedic lesion requiring a potentially painful emergency therapeutic action (reduction of a joint dislocation or realignment of a limb displaced fracture) • Signed free informed consent or inclusion in the context of an emergency situation |
- majeur de plus de 18 ans - indication de sédation procédurale posée par le médecin urgentiste dans le cadre de la prise en charge d’un patient porteur d’une lésion orthopédique nécessitant un acte thérapeutique urgent potentiellement douloureux (réduction de luxation d’articulation ou réalignement d’un membre porteur d’une fracture déplacée) - obtention du consentement libre et éclairé du patient
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E.4 | Principal exclusion criteria |
• Patient of more than 18 under legal protection or deprivation of liberty measures • Ongoing pregnancy or breastfeeding women • Patient with the incapacity to give his free informed consent, excepted if the incapacity is induced by the context of the emergency situation (inclusion in the context of an emergency situation) • Known hypersensitivity to propofol or one of the excipients, egg, soja or peanuts • ASA comorbidity score of 4 or more • Heart, respiratory, renal or hepatic failure • Epilepsy • Lipid metabolism disorder • Mitochondrial disease • Hemodynamic instability, multiple traumatism • Elevated intracranial tension • Drug or alcohol intoxication |
- déclaration verbale par la patiente d’une grossesse connue en cours - incapacité de donner son consentement libre et éclairé - personne majeure faisant l’objet d’une protection légale, ou privée de liberté - non affiliation à la Sécurité Sociale - score de comorbidités ASA > 3 - hypersensibilité connue au propofol ou à l'un des excipients - personne épileptique - personne présentant des troubles du métabolisme des lipides - personne présentant une pression intracrânienne élevée - personne souffrant d’insuffisance cardiaque, respiratoire, rénale ou hépatique - personne hypovolémique ou affaiblie - personne présentant une maladie mitochondriale - allergie à l’œuf ou au soja ou aux arachides - intoxication médicamenteuse ou alcoolique - instabilité hémodynamique et/ou polytraumatisme
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E.5 End points |
E.5.1 | Primary end point(s) |
Propofol brain concentration necessary for the patient to reach a Ramsay score of 5 (optimal sedation) (Ce_Ramsay5) |
concentration cérébrale de propofol en μg/ml ayant permis une sédation suffisante (Ramsay = 5) et permettant de réaliser confortablement le geste de réduction. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Between the beginning of sedation (T0) and the beginning of the orthopedic procedure (T_Ramsay5) to be determined as a secondary outcome as described below (up to an anticipated average maximal value of 15 minutes after T0) |
entre le début de la sédation et le début de la procédure orthopédique (=score Ramsay =5) |
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E.5.2 | Secondary end point(s) |
Delay between the beginning of sedation (T0) and the beginning of the orthopedic procedure (T_Ramsay5) |
délai de réveil après l’arrêt de la SIVOC |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
the delay is the outcome, T_Ramsay5 (up to an anticipated average maximal time of 15 minutes after T0)] |
le temps de réveil après l'arrêt de la SIVOC |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLS |
Dernière visite du dernier patient |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | 1 |
E.8.9.2 | In all countries concerned by the trial days | 1 |