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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?

Narcotic Use

Pain

Constipation

Nausea

Study Interventions

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.

Drug:Celebrex

Drug:Gabapentin

Drug:IV acetaminophen

Drug:oral acetaminophen

Drug:oral ibuprofen

Drug:percocet

Drug:vicodin

Drug:Oxycodone

Drug:dilaudid

Drug:Dexamethasone

Drug:zofran

Study Arms

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

Study Status

Completed

Start Date: March 2014

Completed Date: June 2016

Phase: Phase 4

Type: Interventional

Design:

Primary Outcome: Narcotic use

Secondary Outcome: Pain

Study sponsors, principal investigator, and references

Principal Investigator: Krista Reagan, MD

Lead Sponsor: Hartford Hospital

Collaborator:

More information:https://clinicaltrials.gov/show/NCT02110719

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