Morphine in simulated haemorrhagic shock

  • Research type

    Research Study

  • Full title

    Effects of morphine on the cardiovascular response to simulated haemorrhage and injury

  • IRAS ID

    23626

  • Contact name

    Jeremy Henning

  • Contact email

    jeremy.henning@nhs.net

  • Sponsor organisation

    South Tees Hospitals NHS FT

  • Eudract number

    2010-020308-31

  • Duration of Study in the UK

    11 years, 5 months, 7 days

  • Research summary

    Does morphine delay the point of decompensation (blood pressure fall / fainting) during simulated haemorrhage and injury in healthy adult volunteers?

    Morphine is widely used to control pain in trauma casualties. Other effects of morphine, such as cardiovascular effects, are the subject of opinion rather than evidence. There is no data to predict the action of morphine on the cardiovascular system following haemorrhage and injury. There is conflicting data from animal studies following haemorrhage with data from rats and sheep giving opposing findings. The study is important to help clinicians assess injured casualties who have been given morphine and help identify which animal models are most appropriate to comprehensively assess the potential deleterious side-effects of analgesic drugs.

    The study is a prospective randomised controlled trial on healthy young adult volunteers. It will be conducted at James Cook University Hospital. Haemorrhage will be simulated using an established non-invasive technique called ‘lower body negative pressure’ (LBNP). During the test the volunteer will reach the point of fainting (decompensation or pre-syncope), when the test is terminated. The test is not uncomfortable. The test will be repeated twice (minimum 7 days apart), once with and once without morphine. The whole process will be repeated in a further group where injury will be simulated using an established technique where tourniquets (tight ‘bandages’) are applied around the legs. This will involve some discomfort but no lasting harm, which will be explained to the volunteers. The risk of clotting problems is minimised by including only low-risk individuals (healthy volunteers with no history of cardiovascular/clotting problems).

    The measurements (e.g blood pressure, tissue oxygenation) will be non-invasive except for venous pressure (needle/cannula in a vein of the arm) and blood sampling (2 samples of 5 ml). Individuals may take part in both tourniquet and no-tourniquet studies and will therefore attend on 4 occasions. Similar measurements will be made during the pilot phase but this will involve one session and no use of morphine. The study is funded by the Ministry of Defence.

  • REC name

    North East - York Research Ethics Committee

  • REC reference

    10/H0903/38

  • Date of REC Opinion

    24 Mar 2011

  • REC opinion

    Further Information Favourable Opinion