Comparing Narcotic vs. Non-narcotic Pain Regimens After Pediatric Appendectomy: A Randomized Controlled Trial
Overview
- Phase
- Phase 1
- Intervention
- Non-narcotic pain control
- Conditions
- Appendicitis
- Sponsor
- University of Utah
- Locations
- 1
- Primary Endpoint
- Parental pain control satisfaction using Parental Post-operative Pain Measure (PPPM)
- Status
- Withdrawn
- Last Updated
- 6 years ago
Overview
Brief Summary
There is concern that pain prescription after outpatient pediatric surgical procedures is excessive and is in excess of patient need. Current practice following pediatric appendectomy is to prescribe all children with 5-15 doses of narcotic pain medication upon discharge regardless of their age, severity of appendicitis, or pain control in the hospital. This study examines the amount of narcotic pain control required by pediatric patients after undergoing appendectomy using a randomized controlled trial study design.
Pain control will be assessed with a post-operative pain scale, patient satisfaction survey, and parent satisfaction survey on the days following surgery and at post-operative follow-up.
The hypothesis is that the pain scores and patient satisfaction surveys will show no difference in post-operative pain control between the two arms.
Detailed Description
There is concern that pain prescription after outpatient pediatric surgical procedures is excessive and is in excess of patient need. Current practice following pediatric appendectomy is to prescribe all children with 5-15 doses of narcotic pain medication upon discharge regardless of their age, severity of appendicitis, or pain control in the hospital. This study examines the amount of narcotic pain control required by pediatric patients after undergoing appendectomy using a randomized controlled trial study design. Children admitted after undergoing surgical management for a diagnosis of acute appendicitis will be randomized at discharge to a narcotic arm or a tylenol/motrin arm. The narcotic arm will receive the standard of care narcotic prescription. The tylenol/motrin arm will receive education to use tylenol and motrin for pain control as well as a paper prescription provided for the sole purpose of rescue. Pain control will be assessed with a post-operative pain scale, patient satisfaction survey, and parent satisfaction survey on the days following surgery and at post-operative follow-up. The hypothesis is that the pain scores and patient satisfaction surveys will show no difference in post-operative pain control between the two arms.
Investigators
Sean Stokes
General Surgery Resident
University of Utah
Eligibility Criteria
Inclusion Criteria
- •Children ages 0 to 18 years old
- •Patients have undergone appendectomy by any technique (open, laparoscopic, single-port)
Exclusion Criteria
- •Patients on chronic opioids
- •Patient undergoes a more extensive or additional procedures at the time of operation due to complications or other indication
- •Pregnancy
Arms & Interventions
Tylenol/Motrin
Group of patients who will receive instructions to use tylenol and motrin for pain control, and parents will be sent home with a paper prescription with a rescue does of standard of care narcotics. They will be instructed to only use the rescue dose if pain is uncontrolled using over the counter medications.
Intervention: Non-narcotic pain control
Outcomes
Primary Outcomes
Parental pain control satisfaction using Parental Post-operative Pain Measure (PPPM)
Time Frame: 2-week follow-up visit
Parental satisfaction with pain control at home following pediatric appendectomy as assessed by the validated Parental Post-operative Pain Measure (PPPM)
Secondary Outcomes
- Patient pain control satisfaction using adaptation of Parental Post-operative Pain Measure (PPPM)(Changes from in-hospital, days 1-3 following discharge, and 2-week follow-up)
- Parental pain control satisfaction using Parental Post-operative Pain Measure (PPPM)(Changes from in-hospital, days 1-3 following discharge, and 2-week follow-up)
- Days of pain medication requirement after discharge(Post-operative days 1-14 (until follow-up))
- Number of pain medication side effects(Post-operative days 1-14 (until follow-up))
- Patient pain scores using Wong-Baker Faces Pain Rating Scale(Changes from in-hospital, days 1-3 following discharge, and 2-week follow-up)
- Number of pain medications used(Post-operative days 1-14 (until follow-up))