- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT04659317
Ortopedia bez opioidów
Podwójnie ślepa, randomizowana, kontrolowana próba badająca multimodalne procedury ortopedyczne wolne od opioidów
The goal of this investigation is to compare effectiveness of this multimodal regimen at controlling postoperative pain with and without the use of opioid medications.
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Szczegółowy opis
Prolonged opioid usage after orthopaedic surgery is an important consideration for both the opioid epidemic and postoperative outcomes. The investigators have developed a multimodal pain control regimen designed to decrease or even potentially eliminate the need for opioids after an orthopedic procedure. This is a prospective double blinded randomized controlled trial utilizing a multimodal pain regimen consisting of education and our standard multimodal pain control regimen. Then, the plan is to randomize patients to receive either encapsulated opioids or placebo. The team will assess patient's pain levels, satisfaction, opioid usage, side effects, patient reported outcomes, and complications. This study will serve as a foundation for future opioid-free surgeries and investigations, while helping to identify patients and factors at risk for prolonged opioid usage postoperatively.
Typ studiów
Zapisy (Rzeczywisty)
Faza
- Faza 3
Kontakty i lokalizacje
Lokalizacje studiów
-
-
Georgia
-
Atlanta, Georgia, Stany Zjednoczone, 30322
- Emory University Hospital
-
Atlanta, Georgia, Stany Zjednoczone, 30029
- The Emory Clinic
-
Tucker, Georgia, Stany Zjednoczone, 30084
- Emory Orthopedic and Spine Hospital
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
- Any patient with advanced arthritis undergoing a total joint replacement (e.g. total shoulder arthroplasty, anatomic or reverse), in the primary setting.
- Any patient undergoing an orthopaedic procedure or surgery of their finger, hand, wrist, forearm, or elbow
- Any patient undergoing an orthopaedic procedure or surgery for their hip, knee, ankle or foot
- Patients who have exhausted 3+ months of nonoperative treatment to include activity modifications, optional corticosteroid injections, and physical therapy.
- Patients over the age of 18 years old that are willing to participate in the study and mentally capable to consent
Exclusion Criteria:
- Patients with concurrent and significant injuries to other bones or organs, local infections, history of alcohol or medical abuse, preoperative opioid use within 3 months of the surgery, advanced renal or liver disease, contraindication to receiving a nerve block, uncontrolled diabetes mellitus (HbA1C >9.0), or if a prior gastric ulcer precludes Aspirin and anti-inflammatory medications. Prior to inclusion, the patient will undergo blood testing to evaluate both kidney and liver function, including estimated glomerular filtration rate (GFR) as well as alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
- Workman's compensation status, minors, vulnerable subjects, women who are pregnant, or those who are not willing to consent to participate in the study.
- Patients who, in the opinion of the investigator, may be non-compliant with study schedules or procedures
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Poczwórny
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Aktywny komparator: Opioid Group
Participants will receive encapsulated Oxycodone 5 mg tablets x24, to take po q6 hours as needed after surgery Safety" Prescription: Oxycodone5 mg po q6 hours as needed for pain |
Encapsulated Oxycodone 5 mg tablets x24, to take po q6 hours as needed |
|
Eksperymentalny: Placebo Group
Participants will receive encapsulated placebo tablets x24, to take po q6 hours as need for pain after surgery "Safety" Prescription: Oxycodone5 mg po q6 hours as needed for pain |
Encapsulated placebo tablets x24, to take po q6 hours as need for pain |
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Change in Pain (VAS) Score
Ramy czasowe: Three times a day postoperatively for the first 2 weeks, then 3 months, 6 months, 12 months, and 24 months postoperative
|
The investigators will assess patient postoperative pain utilizing a visual analog scale (VAS) for the first 14 days postoperatively. They will also assess pain at each postoperative visit after at 6 weeks, 3 months, 6 months, 12 months and 24 months. This scale will assess pain at 3 different timepoints throughout the day defined as morning, afternoon, and evening. The pain scale will range from 0-10 with 10 being a worse outcome quantifying the highest pain rating. |
Three times a day postoperatively for the first 2 weeks, then 3 months, 6 months, 12 months, and 24 months postoperative
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Postoperative Opioid Consumption
Ramy czasowe: Postoperative Days 1-14
|
Total opioid consumption in Morphine milligram equivalents (MME) during the first 2 weeks after surgery will be measured. |
Postoperative Days 1-14
|
|
Number of participants that required Rescue Opioid Prescription
Ramy czasowe: Postoperative Days 1-14
|
Number of participants that required the prescribed rescue ("safety") opioid prescription during the first 2 postoperative weeks. |
Postoperative Days 1-14
|
|
Number of tables consumed as Rescue Opioid
Ramy czasowe: Postoperative Days 1-14
|
Number of tablets taken from the prescribed rescue ("safety") opioid prescription during the first 2 postoperative weeks. |
Postoperative Days 1-14
|
|
Number of Additional Opioid Prescription Refills
Ramy czasowe: Postoperative Days 1-14
|
Number of additional opioid prescription refills required during the postoperative period. |
Postoperative Days 1-14
|
|
Number of participants experiencing Postoperative Nausea
Ramy czasowe: Three times a day postoperatively for the first 2 weeks
|
Number of participants experiencing nausea during the postoperative period. This scale will assess nausea at 3 different timepoints throughout the day defined as morning, afternoon, and evening. The scale will range from 0-10 with 10 being a worse outcome quantifying the highest nausea rating. |
Three times a day postoperatively for the first 2 weeks
|
|
Hand/Wrist function Measured by the Single Assessment Numeric Evaluation (SANE)
Ramy czasowe: Baseline (Preoperative); and at 3, 6, 12, and 24 months postoperatively.
|
The Single Assessment Numeric Evaluation (SANE) score requires the patient to rate their injured extremity 0-100 as a percentage of their function compared to normal. A rating of 0 is the minimum value and denotes the worse outcome a patient can have on the scale. |
Baseline (Preoperative); and at 3, 6, 12, and 24 months postoperatively.
|
|
Upper Extremity Function Measured by the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH)
Ramy czasowe: Baseline (Preoperative); and at 12 and 24 months postoperatively.
|
Upper extremity disability will be assessed using the QuickDASH questionnaire. Scores range from 0 to 100, with lower scores indicating less disability. |
Baseline (Preoperative); and at 12 and 24 months postoperatively.
|
|
Overall Satisfaction with the procedure and Pain Management
Ramy czasowe: 12 and 24 months postoperatively
|
Overall satisfaction with the surgical procedure and postoperative pain management will be assessed using a patient-reported 5-point rating scale. Participants will select one of the following responses: "Very satisfied", "satisfied", "neutral", "dissatisfied", and "Very dissatisfied". Responses are assigned a score from 1 to 5, where 1 corresponds to "very dissatisfied" and 5 corresponds to "very satisfied". Higher scores indicate greater satisfaction and better perceived outcomes |
12 and 24 months postoperatively
|
|
Willingness to undergo the same procedure with the same pain management
Ramy czasowe: 12 and 24 months postoperatively
|
Number of Participants that confirm their willingness to undergo the same procedure again using the same postoperative pain management regimen. |
12 and 24 months postoperatively
|
|
Number of participants Experiencing Major Postoperative Complications
Ramy czasowe: From surgery through 24 months postoperatively
|
Number of participants experiencing one or more major postoperative complications, including temporary or permanent nerve injury, hematoma, superficial or deep infection, recurrent moderate or severe pain, fracture, implant loosening, dislocation, or revision surgery. |
From surgery through 24 months postoperatively
|
Współpracownicy i badacze
Sponsor
Śledczy
- Główny śledczy: Eric Wagner, MD, Emory University
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Rzeczywisty)
Ukończenie studiów (Rzeczywisty)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Objawy neurologiczne
- Choroby Układu Nerwowego
- Powikłania pooperacyjne
- Procesy patologiczne
- Manifestacje neurobehawioralne
- Zaburzenia percepcyjne
- Stany patologiczne, oznaki i objawy
- Objawy i symptomy
- Ból
- Ból, pooperacyjny
- Agnozja
- Związki heterocykliczne
- Związki heterocykliczne, sterowanie stopieniem
- Przygotowania farmaceutyczne
- Formy dawkowania
- Alkaloidy
- Policykliczne aromatyczne węglowodory
- Związki policykliczne
- Związki heterocykliczne, 4 lub więcej pierścieni
- Morfinany
- Opiatowe alkaloidy
- Związki heterocykliczne, ring mostkowy
- Fenantreny
- Pochodne morfiny
- Kodeina
- Oksykodon
- Tabletki
Inne numery identyfikacyjne badania
- STUDY00000478
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
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