A Randomized, Placebo-controlled Trial of Nitrous Oxide During In-office Bladder Botox Injections

Trial statusNot yet recruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexFemale
Age18+
SponsorTriHealth Inc.

About this trial

The goal of this clinical trial is to assess if a mix of nitrous oxide and oxygen can improve pain control during bladder Botox injections. The primary question it aims to answer is: Does using nitrous oxide lower the overall level of pain during the procedure?

Researchers will compare a 50:50 nitrous oxide/oxygen mixture (administered with the Pro-Nox system) plus standard care (with lidocaine in the bladder) to sham mask plus standard care to see if nitrous oxide works better for lowering pain.

Participants will:

* Receive their bladder Botox injection in the office setting * Either use nitrous oxide/oxygen plus standard care during the procedure, or sham mask plus standard care * Answer brief questions about pain, anxiety, satisfaction, and willingness to repeat the procedure

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adult women ≥18 years old scheduled for in-office intradetrusor botulinum toxin injection and able to consent.

Disqualifiers

Known/suspected vitamin B12 or folate deficiency or high-risk state (e.g., pernicious anemia, malabsorption, post-bariatric or strict vegan without supplementation)

currently pregnant

severe/unstable pulmonary disease or baseline hypoxemia requiring supplemental home oxygen

eye or ear surgery in the last six weeks

Trial design

Design model

Parallel

Treatments tested in this trial

  • Pro-Nox Nitrous Oxide/Oxygen Delivery System

    Drug

    The Pro-Nox system delivers a fixed 50:50 mixture of nitrous oxide and oxygen for patient self-administered inhaled analgesia. Participants will self-administer nitrous oxide throughout the in-office bladder Botox procedure.

  • Standard Care for Bladder Botox Injection

    Drug

    Standard care includes intravesical instilled 1-2% lidocaine with a dwell time of at least 15 minutes before the procedure.

  • Sham Mask

    Other intervention

    The Sham Mask will involve that participant using the same mask as that of the Nitrous Oxide group, but connected to a Pro-Nox system that is turned completely off. They will therefore receive room air through the mask.

Treatment groups

96 Participants
are divided into 2 treatment groups
Group A: Sham Mask Plus Standard CareActive comparator 2 interventions
Group B: Nitrous Oxide Plus Standard CareExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Overall Pain (10-point NRS)

Patient self-reported overall pain during the procedure on an 11-point numeric rating scale.

Time frame
At least 3 minutes after completion of the procedure.

Secondary outcomes

1

Peak Pain (10-point NRS)

Patient self-reported peak pain during the procedure on an 11-point numeric rating scale.

Time frame
At least 3 minutes after completion of the procedure.
2

Peak Pain Timing

Patient self-reported timing of peak pain during the procedure, as it corresponds to different steps during the procedure.

Time frame
At least 3 minutes after completion of the procedure.
3

Overall Anxiety (10-point NRS)

Patient self-reported overall anxiety during the procedure on an 11-point numeric rating scale.

Time frame
At least 3 minutes after completion of the procedure.
4

Satisfaction with Pain Management (10-point NRS)

Patient self-reported satisfaction with pain management during the procedure on an 11-point numeric rating scale.

Time frame
At least 3 minutes after completion of the procedure.

Other outcomes

1

Nitrous Interest (5-point Likert)

Patient self-reported interest in use of nitrous oxide for pain and anxiety management in a future procedure, on a 5-point Likert scale.

Time frame
At least 3 minutes after completion of the procedure.
2

Adverse Effects

Physician reported adverse events encountered peri-operatively.

Time frame
Immediately following the procedure. Completed by performing surgeon.
3

Blinding Assessment

Patient self-reported perceived treatment assignment (nitrous oxide/oxygen vs sham mask), recorded as nitrous oxide, sham mask, or unsure.

Time frame
At least 3 minutes after completion of the procedure.

Sponsors and contacts

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