- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03845881
Trial Comparing a Multi-Modal Pain Protocol With and Without Opioids Following Total Joint Arthroplasty
July 29, 2020 updated by: Benjamin K. Wilke, Mayo Clinic
A Randomized, Double-Blinded, Placebo-Controlled Trial Comparing a Multi-Modal Pain Protocol With and Without Opioids Following Total Joint Arthroplasty
To help curb the use of opioid medications following orthopedic surgery investigators have developed a new multi-modal pain pathway.
Investigators aim to compare this regimen with and without the inclusion of opioid medications.
This study will be performed in a randomized, double-blinded, placebo-controlled fashion in patients undergoing primary total knee or total hip arthroplasty.
Investigators hypothesize that the opioid devoid pathway will show equivalent pain scores to the pathway that includes opioids while also having less constipation, nausea, and vomiting following surgery.
If successful, this would create a dramatic decrease in opioid consumption following orthopedic surgery while still providing appropriate pain relief to patients.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
- Aim 1 will be to compare the postoperative pain levels both in the hospital setting as well as daily for two weeks following discharge between patients in the opioid treatment group and those in the non-opioid treatment group. This will be performed with clinical exams while in the hospital and with phone surveys on discharge. Results will be recorded using the Visual Analog Scale for pain scores.
- Aim 2 will be to compare the overall morphine equivalents used during hospitalization between the opioid and non-opioid treatment groups. This will be calculated based on the amount of intravenous breakthrough narcotic pain medication used in the hospital setting (divided by the total number of post-surgery hospitalization hours to account for varying lengths of stay). Investigators will also measure the total number of opioid pills (these would be placebo pills for the non-opioid group) consumed during the first two weeks post-discharge, and the post-surgery day on which opioid pills were discontinued, and compare these outcomes between the opioid and non-opioid groups.
- Aim 3 will be to compare postoperative constipation, nausea, and vomiting between the two treatment groups. This will be assessed with daily clinical examinations while in the hospital and with daily phone surveys on discharge. Constipation will be recorded as presence or absence, while nausea and vomiting will be measured using the Postoperative Nausea and Vomiting Scale.
- Aim 4 will be to compare the length of post-surgery hospitalization between the two treatment groups.
Study Type
Interventional
Enrollment (Actual)
45
Phase
- Early Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Florida
-
Jacksonville, Florida, United States, 32224
- Mayo Clinic in Florida
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 89 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age > 18 and < 90 years.
- Willing to participate in the study and competent to provide informed consent.
- Willing to comply with protocol procedures.
- Has an underlying diagnosis of osteoarthritis indicated for knee arthroplasty.
Exclusion Criteria:
- A diagnosis of renal or liver disease
- If a patient has a contraindication to receiving a spinal anesthetic or pain catheter
- The patient must not have taken any narcotic medications during the 3 months leading up to the surgery
- The patient must not be allergic or intolerant to a medication used in the multi-modal pain pathway
- Revision hip or knee arthroplasty
- If a patient is being treated under worker's compensation
- If a patient has diabetes
- Unable to take Aspirin 325 mg twice daily for deep venous thromboprophylaxis
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Opioid
Multi-Modal Pain Protocol with Opioids Following Total Joint Arthroplasty
|
The primary endpoint will be pain scores, calculated by the Visual Analog Scale.
This score will be collected daily during the hospital examination and by phone surveys for two weeks following discharge.
Investigators hypothesize that the non-opioid pain regimen will provide equivalent relief as compared to the opioid regimen.
|
Placebo Comparator: Non Opioid
Multi-Modal Pain Protocol without Opioids Following Total Joint Arthroplasty
|
The primary endpoint will be pain scores, calculated by the Visual Analog Scale.
This score will be collected daily during the hospital examination and by phone surveys for two weeks following discharge.
Investigators hypothesize that the non-opioid pain regimen will provide equivalent relief as compared to the opioid regimen.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain Levels
Time Frame: 2 weeks
|
compare the postoperative pain levels both in the hospital setting as well as daily for two weeks following discharge between patients in the opioid treatment group and those in the non-opioid treatment group.
This will be performed with clinical exams while in the hospital and with phone surveys on discharge.
Results will be recorded using the Visual Analog Scale for pain scores.
This scale ranges from 0 to 10, with zero being no pain and 10 being as bad as can be, and includes visual facial cues.
Following this scale, investigators will also ask about sleep, activity, mood, and stress.
|
2 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Opioid Levels
Time Frame: 2 weeks
|
compare the overall morphine equivalents used during hospitalization between the opioid and non-opioid treatment groups.
This will be calculated based on the amount of intravenous breakthrough narcotic pain medication used in the hospital setting (divided by the total number of post-surgery hospitalization hours to account for varying lengths of stay).
Investigators will also measure the total number of opioid pills (these would be placebo pills for the non-opioid group) consumed during the first two weeks post-discharge, and the post-surgery day on which opioid pills were discontinued, and compare these outcomes between the opioid and non-opioid groups.
|
2 weeks
|
Side effects
Time Frame: 2 weeks
|
compare postoperative constipation, nausea, and vomiting between the two treatment groups.
This will be assessed with daily clinical examinations while in the hospital and with daily phone surveys on discharge.
Constipation will be recorded as presence or absence, while nausea and vomiting will be measured using the Postoperative Nausea and Vomiting Scale.
This scaled is based off 2 questions related to nausea and vomiting which will be added together for a total score.
Responses range from 0 to 3 and a total score of greater than or equal to 5 will be defined as clinically important.
|
2 weeks
|
Length of hospitalization
Time Frame: 2 weeks
|
compare the length of post-surgery hospitalization between the two treatment groups.
|
2 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Benjamin Wilke, MD, Mayo Clinic
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
April 10, 2019
Primary Completion (Actual)
July 28, 2020
Study Completion (Actual)
July 28, 2020
Study Registration Dates
First Submitted
February 11, 2019
First Submitted That Met QC Criteria
February 16, 2019
First Posted (Actual)
February 19, 2019
Study Record Updates
Last Update Posted (Actual)
July 30, 2020
Last Update Submitted That Met QC Criteria
July 29, 2020
Last Verified
July 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 18-004256
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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