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Opioidfri ortopedi

10 november 2026 uppdaterad av: Eric Wagner, Emory University

En dubbelblind randomiserad kontrollerad studie som undersöker multimodala opioidfria ortopediska procedurer

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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

56

Fas

  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30322
        • Emory University Hospital
      • Atlanta, Georgia, Förenta staterna, 30029
        • The Emory Clinic
      • Tucker, Georgia, Förenta staterna, 30084
        • Emory Orthopedic and Spine Hospital

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv 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
Läkemedel: Oxycodone 5 mg Oral Tablet

Encapsulated Oxycodone 5 mg tablets x24, to take po q6 hours as needed
Experimentell: 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
Läkemedel: Placebo oral tablet

Encapsulated placebo tablets x24, to take po q6 hours as need for pain

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in Pain (VAS) Score
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Postoperative Opioid Consumption
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Emory University

Utredare

  • Huvudutredare: Eric Wagner, MD, Emory University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

11 december 2020

Primärt slutförande (Faktisk)

20 juli 2026

Avslutad studie (Faktisk)

20 juli 2026

Studieregistreringsdatum

Först inskickad

30 november 2020

Först inskickad som uppfyllde QC-kriterierna

7 december 2020

Första postat (Faktisk)

9 december 2020

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

13 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • STUDY00000478

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

produkt tillverkad i och exporterad från U.S.A.

Nej

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