Efficacy of NSAID and Acetaminophen in the Control of Post-Operative Pain in Patients Undergoing Total Knee Replacement
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
Acute pain after a surgical procedure may occur secondary to trauma from the procedure itself or from procedure-related complications. Appropriate peri-operative acute pain management is an important phase of patient's recovery since it's under-treatment can lead to adverse outcomes such as: thromboembolic and pulmonary complications, additional time spent in an intensive care unit or hospital, hospital readmission for further pain management, needless suffering, impairment of health-related quality of life, and development of chronic pain. Furthermore, it's over-treatment with opioid medications is associated with an increased risk of thromboembolic, infectious and gastrointestinal complications as well as increased length of hospital stay, cost of care and risk of opioid addiction.
Perioperative administration of intravenous (IV) non steroidal anti-inflammatory drugs (NSAID), such as ketorolac, has been shown to effectively decrease opioid requirements and pain levels while demonstrating tolerable side effects. Its use after total knee replacement has been associated with a 27% decrease in the use of morphine. When NSAID is combined with acetaminophen 1000mg every six hours, an additional benefit in terms of improved pain scores on post-operative day three was shown in patients who underwent total hip or knee arthroplasty. Therefore, the purpose of this study is to provide an effective alternative for pain management in Hispanic patients who underwent total knee replacement and evaluate the role of ketorolac and acetaminophen.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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San Juan, Porto Rico, 00936
- University of Puerto Rico Medical Sciences Campus, Ortopaedic Surgery Department
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Hispanic American patients undergoing primary total knee arthroplasty
- Older than 21 years of age
- Classified with an American Society of Anesthesiologist Classification (ASA) of I or II.
Exclusion Criteria:
- Hypersensitivity to any components of analgesic drugs
- Impaired renal, cardiac, or hepatic function
- Baseline serum creatinine level higher than 1.2mg/dL
- History of gastrointestinal bleeding
- Neuromuscular deformities
- Inability to consent
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Opioid Sparing Multimodal Regimen
After surgery, the experimental group will receive a combination of ketorolac 30 mg intravenous (IV) every six hours for patients younger than 65 years old or ketorolac 15mg IV every six hours for those older than 65 years old; and acetaminophen 1 gram by mouth (PO) every six hours up to 72 hours
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Use of combination of drug dosage frequency and duration of ketorolac injection with acetaminophen oral as standard postoperative pain control for up to 72 hours as requested by each patient
Outros nomes:
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Experimental: Opioid Based Multimodal Regimen
After surgery, the control group will receive a combination of morphine 0.1 mg/kg IV every six hours and oxycodone combined with acetaminophen (2.5 mg / 325 mg) two tabs PO every six hours up to 72 hours
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Use of combination of drug dosage frequency and duration of morphine injection with percocet oral as standard postoperative pain control for up to 72 hours as requested by each patient
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Pain scores using numerical rating scale (NRS, 0 to 10)
Prazo: Post-operative 12 hours after surgery
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The amount of pain intensity reported will be measure throughout the numerical rating scale.
Each patient will rate their pain intensity on a scale from 0 to 10, where zero represents "no pain," whereas 10 represents the "most intense pain" (e.g., "the most intense pain imaginable," "the maximum pain intensity as it could be"); during the 12 hours postoperative period
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Post-operative 12 hours after surgery
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Pain scores using numerical rating scale (NRS, 0 to 10)
Prazo: Post-operative 24 hours after surgery
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The amount of pain intensity reported will be measure throughout the numerical rating scale.
Each patient will rate their pain intensity on a scale from 0 to 10, where zero represents "no pain," whereas 10 represents the "most intense pain" (e.g., "the most intense pain imaginable," "the maximum pain intensity as it could be"); during the 24 hours postoperative period
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Post-operative 24 hours after surgery
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Pain scores using numerical rating scale (NRS, 0 to 10)
Prazo: Post-operative 48 hours after surgery
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The amount of pain intensity reported will be measure throughout the numerical rating scale.
Each patient will rate their pain intensity on a scale from 0 to 10, where zero represents "no pain," whereas 10 represents the "most intense pain" (e.g., "the most intense pain imaginable," "the maximum pain intensity as it could be"); during the 48 hours postoperative period
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Post-operative 48 hours after surgery
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Hospital Length of Stay
Prazo: up to 30 days
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The number of days per patient from the time of admission to discharge up to 30 days
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up to 30 days
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Drug-related adverse events
Prazo: From the time of surgery after being discharge (0 to 72 hours after surgery)
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nausea, dizziness, vomit, tachycardia, pruritus and headache
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From the time of surgery after being discharge (0 to 72 hours after surgery)
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Antonio Otero-Lopez, MD, Orthopaedic Surgery Section, University of Puerto Rico Medical Sciences Campus San Juan, Puerto Rico
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Processos Patológicos
- Complicações pós-operatórias
- Dor
- Manifestações Neurológicas
- Dor, Pós-operatório
- Efeitos Fisiológicos das Drogas
- Mecanismos Moleculares de Ação Farmacológica
- Depressores do Sistema Nervoso Central
- Agentes do Sistema Nervoso Periférico
- Inibidores Enzimáticos
- Analgésicos
- Agentes do Sistema Sensorial
- Agentes anti-inflamatórios não esteróides
- Analgésicos, Não Narcóticos
- Antiinflamatórios
- Agentes Antirreumáticos
- Inibidores da Ciclooxigenase
- Antipiréticos
- Narcóticos
- Cetorolaco
- Paracetamol
- Morfina
- Analgésicos, Opioides
Outros números de identificação do estudo
- B0110219
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Ensaios clínicos em Opioid sparing protocol
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Ankara Yildirim Beyazıt UniversityConcluídoFunção cognitiva | Função Muscular | Músculos isquiotibiais | Turco Levante-sePeru