Narcotic Use | Decreasing Narcotics in Advanced Pelvic Surgery
Narcotic Use research study
What is the primary objective of this study?
In recent years, there has been an emphasis on the creation of \"enhanced-recovery\", \"fast-track\" or \"multi-modal\" pathways to improve perioperative care (1-4). The goal of these programs is to reduce the length of hospital stay, decrease narcotic usage while improving pain control, accelerate post-operative recovery, and expedite return to baseline functional status. Pathways often are developed by a team of surgeons, nurses, pain specialists, anesthesiologists and other support staff. Postoperative components often involve multi-modal analgesia, early return to activity and early return to a regular diet. The goal of this study is to evaluate the efficacy of a multi-modal pain regimen in advanced pelvic surgery with a primary goal of decreasing narcotic usage.
Who is eligible to participate?
Inclusion Criteria: - women >/= 18 years old - undergoing pelvic organ prolapse or incontinence surgery with the Urogynecology department Exclusion Criteria: - males - <18 years old - women unwilling or unable to consent - same-day-discharge surgery - history of chronic pain for which they use medications - current or active history of narcotic abuse - sleep apnea - liver or kidney dysfunction - sulfa allergy
Which medical condition, disease, disorder, syndrome, illness, or injury is researched?
Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.
Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.
StandardPatients will be given the following: no preoperative medications intraoperative medications per anesthesia postoperatively, patients will receive ibuprofen, tylenol and narcotics as needed
MultimodalPatients in the multimodal arm will receive the following: preoperative celebrex and gabapentin intraoperative IV acetaminophen, dexamethasone, zofran postoperative scheduled IV acetaminophen, PO celebrex and gabapentin, and as needed PO narcotics patient will be discharged on scheduled ibuprofen and acetaminophen for 3 days followed by "as needed" use as well as "as needed" narcotics
Start Date: March 2014
Completed Date: June 2016
Phase: Phase 4
Primary Outcome: Narcotic use
Secondary Outcome: Pain
Study sponsors, principal investigator, and references
Principal Investigator: Krista Reagan, MD
Lead Sponsor: Hartford Hospital