MedPath

Opioid Use After Laparoscopic Salpingectomy

Phase 4
Recruiting
Conditions
Opioid Use
Post-operative Pain
Sterility, Female
Interventions
Registration Number
NCT06434233
Lead Sponsor
Johns Hopkins University
Brief Summary

The purpose of this study is to evaluate patient-reported post-operative pain scores following minimally invasive tubal sterilization procedures to determine if a multimodal, non-opioid pain control regimen is non-inferior to a pain control regimen including opioids.

The study team hypothesizes that with extensive counseling on pain management, multimodal medication use, and expectation with non-opioid methods can effectively eliminate the need for opioid prescriptions after laparoscopic salpingectomy.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
120
Inclusion Criteria
  • Individuals with a fallopian tube (unilateral and/or bilateral)
  • Age 18 years old and above
  • Undergoing minimally invasive (laparoscopic or robotic) unilateral or bilateral salpingectomy or other tubal sterilization procedure as the primary procedure
  • Benign indications for salpingectomy/tubal sterilization
  • Agreeing to participate
Exclusion Criteria
  • Chronic pain syndromes patients including fibromyalgia
  • Patients currently on long-term (i.e. for more than three months) opioid use
  • Conversion to laparotomy
  • Allergy or other contraindication to the prescribed medications such as acetaminophen or oxycodone
  • Salpingectomy that occurs in conjunction with a major Gyn surgery (i.e. hysterectomy, etc)
  • Salpingectomy performed for treatment of ectopic pregnancy
  • Patients with a history of gastritis and/or GI bleeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1 - Opioid Post-Op Pain RegimenAcetaminophenPatients randomized to Arm 1 will receive the current most commonly prescribed pain control regimen after a minimally invasive tubal sterilization procedure at discharge. These medications include: Tylenol 500 mg orally every 6 hours scheduled x 30 tablets Ibuprofen 600 mg orally every 6 hours scheduled x 30 tablets and Oxycodone 5 mg orally every 4 hours as needed x 12 tablets All patients will be instructed to use Acetaminophen and Ibuprofen around the clock for the first 72 hours and as needed thereafter
Arm 1 - Opioid Post-Op Pain RegimenIbuprofenPatients randomized to Arm 1 will receive the current most commonly prescribed pain control regimen after a minimally invasive tubal sterilization procedure at discharge. These medications include: Tylenol 500 mg orally every 6 hours scheduled x 30 tablets Ibuprofen 600 mg orally every 6 hours scheduled x 30 tablets and Oxycodone 5 mg orally every 4 hours as needed x 12 tablets All patients will be instructed to use Acetaminophen and Ibuprofen around the clock for the first 72 hours and as needed thereafter
Arm 1 - Opioid Post-Op Pain RegimenOxycodonePatients randomized to Arm 1 will receive the current most commonly prescribed pain control regimen after a minimally invasive tubal sterilization procedure at discharge. These medications include: Tylenol 500 mg orally every 6 hours scheduled x 30 tablets Ibuprofen 600 mg orally every 6 hours scheduled x 30 tablets and Oxycodone 5 mg orally every 4 hours as needed x 12 tablets All patients will be instructed to use Acetaminophen and Ibuprofen around the clock for the first 72 hours and as needed thereafter
Arm 2 - Non-Opioid Post-Op Pain RegimenIbuprofenPatients randomized to Arm 2 will not receive an opioid prescription after minimally invasive tubal sterilization procedures at discharge. They will receive only Tylenol and Ibuprofen as follows: Tylenol 500 mg orally every 6 hours scheduled x 30 tablets Ibuprofen 600 mg orally every 6 hours scheduled x 30 tablets and All patients will be instructed to use Acetaminophen and Ibuprofen around the clock for the first 72 hours and as needed thereafter. Participants will be informed that if they need additional pain medications, these will not be withheld. Participants in the second arm who require additional pain medications will receive the same amount of oxycodone as in arm 1.
Arm 2 - Non-Opioid Post-Op Pain RegimenAcetaminophenPatients randomized to Arm 2 will not receive an opioid prescription after minimally invasive tubal sterilization procedures at discharge. They will receive only Tylenol and Ibuprofen as follows: Tylenol 500 mg orally every 6 hours scheduled x 30 tablets Ibuprofen 600 mg orally every 6 hours scheduled x 30 tablets and All patients will be instructed to use Acetaminophen and Ibuprofen around the clock for the first 72 hours and as needed thereafter. Participants will be informed that if they need additional pain medications, these will not be withheld. Participants in the second arm who require additional pain medications will receive the same amount of oxycodone as in arm 1.
Primary Outcome Measures
NameTimeMethod
Numeric post-operative pain scorepost-operative day 1 and post-operative day 7

Patient reported pain on "Post-Operative Day 1 Survey" and "Post-Operative Day 7 Survey" using the Likert pain scale from 0 to 10, where 0 is no pain and 10 is severe pain. A higher score indicates a worse outcome.

Secondary Outcome Measures
NameTimeMethod
Satisfaction with post-operative pain reliefpost-operative day 1 and post-operative day 7

As indicated on "Post-Operative Day 1 Survey" and "Post-Operative Day 7 Survey" by a binary "yes" or "no" response. "Yes" indicates a favorable outcome and "no" indicates a worse outcome.

Satisfaction with post-operative mobilitypost-operative day 1 and post-operative day 7

As indicated on "Post-Operative Day 1 Survey" and "Post-Operative Day 7 Survey" by a binary "yes" or "no" response. "Yes" indicates a favorable outcome and "no" indicates a worse outcome.

Total narcotic consumption at one week post-operativepost-operative day 7

Number of Oxycodone pills used by each patient by the end of post-operative day 7

Occurrence of defined opioid related side effects (N/V, constipation, dizziness, itchiness)post-operative day 1 and post-operative day 7

As indicated on "Post-Operative Day 1 Survey" and "Post-Operative Day 7 Survey" by a binary "yes" or "no" response. "No" indicates a favorable outcome and "yes" indicates a worse outcome.

Suboptimal pain control as assessed by the number of patients requesting additional medication or seeking unplanned medical care for a post-surgical pain-related concernWithin 30 days of surgery

Number of patients who request additional pain medications at the time of post-operative surveys, call provider phone line for additional pain medications, or return to an Emergency Department, clinic/office, etc due to a pain related issue.

Trial Locations

Locations (1)

Johns Hopkins Bayview Medical Center

🇺🇸

Baltimore, Maryland, United States

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