Pain Control With Ketorolac and Nerve Block After Wrist and Hand Surgery

A Pilot Study to Assess Pain Control With Ketorolac and Nerve Block After Wrist and Hand Surgery

The purpose of this study is to learn about the effectiveness of different pain control options after hand and wrist surgery, specifically Ketorolac, Tylenol, and a regional nerve block. Ketorolac (Toradol) is a nonsteroidal anti-inflammatory drug (NSAID) that is similar to ibuprofen (Motrin or Advil). Tylenol (acetaminophen) is a commonly used over the counter drug. A nerve block is pain medication that is applied directly to the nerves around the surgical site before the surgery and keeps working to reduce pain in the area for several hours after the surgery. All of these medicines and procedures are approved by the Food and Drug Administration (FDA) for patient care. This study aims to understand if using these medicines in combination helps patients having hand and wrist surgery avoid the need for opioid pain medications.

Study Overview

• Status: Recruiting
• Conditions: Surgery, Upper Extremity
• Intervention / Treatment: Drug: Toradol; Drug: Oxycodone

Detailed Description

Participants will be enrolled in two sequential groups:

• The first group will be consented for a post-operative pain control regimen consisting of an intraoperative regional nerve block and 3 days of round-the-clock oral ketorolac, plus prescription strength acetaminophen as needed. These analgesic elements are standard of care for patients undergoing the procedures of interest, as an alternative to opioid use, though subjects of this study will be asked to use them as first-line therapy and receive other medications only for breakthrough pain.
• The second group will be consented for a post-operative pain control regimen consisting of a standard care regimen of intraoperative regional nerve block and 3 days of round-the-clock opioids.

Patients in both groups will be asked to complete surveys in which they rate their pain score and describe what medications they have taken for pain.

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: Jennifer Wolf, MD; Phone Number: 773-795-3583; Email: jwolf@bsd.uchicago.edu

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60637
      • Recruiting
      • University of Chicago

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Age 18 years or older
2. Undergoing upper extremity surgery performed by a hand and upper extremity orthopaedic surgeon at the University of Chicago.
3. Undergoing procedure with regional nerve block

Exclusion Criteria:

1. Age less than 18 years
2. Concomitant chronic opioid use
3. Postoperative opioid use (surgery through POD 14) for condition other than repaired fracture
4. Medical contraindication to ketorolac use, including pregnancy
5. Undergoing multiple concurrent surgical procedures
6. Unable to communicate numerical pain score

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Non-Opioid; Regional Nerve Block + Ketorolac (Toradol) + Tylenol (acetaminophen)	Drug: Toradol; Regional Nerve Block + Toradol + Acetaminophen
Active Comparator: Opioid; Regional Nerve Block + Oxycodone (5mg, 10 tablets) + Tylenol (acetaminophen)	Drug: Oxycodone; Regional Nerve Block + Oxycodone + Acetaminophen

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Pain, as measured by the Numeric Pain Scale	The numerical pain rating scale is used for rating postoperative pain. Pain scores rate from 0 to 10, with higher scores indicating more severe pain.	2 days, 1 week and 2 weeks post op

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Opioid requirements, measured in oral morphine equivalents	Opioid requirements for breakthrough pain will be measured in Ketorolac (Toradol) group in Oral Morphine Equivalents (OME).	Through 2 weeks postop

Collaborators and Investigators

• Sponsor: University of Chicago

Study record dates

Study Major Dates

• Study Start (Actual): March 17, 2025
• Primary Completion (Estimated): February 1, 2027
• Study Completion (Estimated): February 1, 2027

Study Registration Dates

• First Submitted: August 14, 2026
• First Submitted That Met QC Criteria: August 14, 2026
• First Posted (Actual): August 19, 2026

Study Record Updates

• Last Update Posted (Actual): August 19, 2026
• Last Update Submitted That Met QC Criteria: August 14, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Keywords: Wrist Surgery, Hand Surgery, Pain Management
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Agnosia; Heterocyclic Compounds; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Alkaloids; Polycyclic Aromatic Hydrocarbons; Polycyclic Compounds; Indomethacin; Indoles; Heterocyclic Compounds, 4 or More Rings; Morphinans; Opiate Alkaloids; Heterocyclic Compounds, Bridged-Ring; Phenanthrenes; Morphine Derivatives; Codeine; Ketorolac Tromethamine; Oxycodone
• Other Study ID Numbers: IRB22-1616

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No current plan to share data

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