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Narcotics Inpatient / Outpatient

9. april 2019 opdateret af: Insiyyah Patanwala, Indiana University

Comparison of Inpatient Narcotics Use to Outpatient Prescription Narcotics Post-operatively

Managing pain in postoperative patients presents challenges in striking a balance between achieving adequate pain control and over-prescribing opioids that have the potential to contribute to the opioid epidemic. There are no clear guidelines informing postoperative opioid prescribing in obstetrics and gynecology.

The primary aim for this study are to better understand the factors that impact opioid use for pain management in gynecologic surgery patient after discharge. The second aim is to develop a model that incorporates individual patient baseline measures (e.g. anxiety, fibromyalgia score, inpatient narcotic consumption) to predict the amount of opioids needed following discharge.

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

Managing pain in postoperative patients presents challenges in striking a balance between achieving adequate pain control and over-prescribing opioids that have the potential to contribute to the opioid epidemic. There are no clear guidelines informing postoperative opioid prescribing in obstetrics and gynecology. A recent study by As-Sanie et al. demonstrated that gynecologists at a large academic medical center prescribe twice the amount of opioids than the average patient uses after hysterectomy.1 Similarly, a study completed at Vanderbilt University Medical Center showed that obstetricians were overprescribing narcotics to patients after cesarean deliveries.2

In addition to rates of opioid prescribing, other factors affect postoperative opioid consumption, including individual patient measures of anxiety, depression, and self-reported pain scores prior to surgery. Preoperative Fibromyalgia symptom scores, STAIT state anxiety scores and NRS pain expectations are independent predictors for morphine consumption following hysterectomy.

There is a pressing need to better understand the factors that impact opioid use in women who undergo gynecologic surgery in order to mitigate the over-use of opioids for pain control upon discharge from the hospital.

Aims:

  1. Understand the factors that impact opioid use for pain management in gynecologic surgery patients after discharge.

    1. Is opioid consumption during the immediate postoperative recovery phase associated with consumption after discharge?
    2. Are variables that are known to be associated with opioid consumption, also associated with opioid consumption after discharge?
    3. Are there factors which we can use to predict opioid consumption in postoperative patients?
  2. Develop a model that incorporates individual patient baseline measures (e.g. anxiety, fibromyalgia score, inpatient narcotic consumption) to predict the amount of opioids needed following discharge.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Indiana
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Indiana University
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Methodist Hospital
      • Indianapolis, Indiana, Forenede Stater, 46202
        • Eskenazi Health Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

N/A

Køn, der er berettiget til at studere

Kvinde

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Subjects who are 18 years old or older who will have a vaginal , laparoscopic, or robotic surgery who require observation of an inpatient stay post-operatively.

Beskrivelse

Inclusion Criteria:

  • 18 years old or older
  • Undergoing vaginal, laparoscopic or robotic gynecologic surgery requiring observation or inpatient stay overnight
  • Agree to receiving contact from research staff for follow up
  • Can provide two telephone numbers or a telephone number and email address

Exclusion Criteria:

  • Unable to provide informed consent
  • Age <18
  • Intolerance/allergy to more than two narcotic medications
  • Allergy/contraindication to non-steroidal anti-inflammatory drugs (NSAIDs)
  • Has a diagnosed gynecologic malignancy other than Grade 1 endometrial cancer
  • Pregnant
  • Current opioid use on a regular basis (more than twice per week)
  • Illicit drug-use within the past 30 days

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: Kohorte
  • Tidsperspektiver: Fremadrettet

Kohorter og interventioner

Gruppe / kohorte
Subjects who undergo gynecologic surgery
Subjects who will undergo gynecologic surgery via vaginally, laparoscopic , or robotic who require observation or inpatient stay overnight. This group will receive pain medication in the hospital and will also be discharged home with pain medication.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Understand the factors that impact opioid use for pain management in gynecologic surgery patients after discharge.
Tidsramme: 1 year
  1. Is opioid consumption during the immediate postoperative recovery phase associated with consumption after discharge?
  2. Are variables that are known to be associated with opioid consumption, also associated with opioid consumption after discharge?
  3. Are there factors which we can use to predict opioid consumption in postoperative patients?
1 year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Develop a model
Tidsramme: 1 year
2. Develop a model that incorporates individual patient baseline measures (e.g. anxiety, fibromyalgia score, inpatient narcotic consumption) to predict the amount of opioids needed following discharge.
1 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Insiyyah Y Patanwala, Indiana School of Medicine

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

23. august 2018

Primær færdiggørelse (Faktiske)

1. januar 2019

Studieafslutning (Faktiske)

1. januar 2019

Datoer for studieregistrering

Først indsendt

31. oktober 2018

Først indsendt, der opfyldte QC-kriterier

31. oktober 2018

Først opslået (Faktiske)

2. november 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

11. april 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. april 2019

Sidst verificeret

1. april 2019

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 1805708779

Plan for individuelle deltagerdata (IPD)

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Uafklaret

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