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RCT (Randomized Controlled Trial) of IV Acetaminophen for Post Operative Vaginal Reconstruction Pain

Phase 4
Completed
Conditions
Post Operative Pain
Interventions
Registration Number
NCT02043704
Lead Sponsor
TriHealth Inc.
Brief Summary

This randomized controlled trial will evaluate the effects of perioperative intravenous (IV) acetaminophen on postoperative narcotic consumption and pain scores in subjects undergoing vaginal reconstructive surgery. One hundred subjects will be randomly assigned to receive either IV acetaminophen or IV placebo. Those in the IV acetaminophen group will receive 1000mg IV every 6 hours for 24 hours beginning prior to anesthesia induction. The control group will receive placebo saline infusions at the same time intervals. All subjects will receive as needed (prn) IV narcotic for additional pain relief. Visual analog scales (VAS) regarding pain will be evaluated at 18 and 24 hours postoperative and immediately prior to discharge. We will also collect total IV narcotic consumption. We hypothesize that subjects receiving IV acetaminophen will have lower VAS scores and decreased total narcotic consumption in comparison to the control group.

Detailed Description

see brief summary

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
100
Inclusion Criteria
  • Women between the ages of 18 and 70 years
  • Patients of the Division of Urogynecology at Good Samaritan and Bethesda North Hospitals in Cincinnati, Ohio
  • Scheduled to undergo major vaginal reconstruction
  • Must undergo total vaginal hysterectomy, anterior repair, posterior repair, enterocele repair, and intraperitoneal vault suspension. The addition of suburethral sling is not a cause for exclusion.
Exclusion Criteria
  • Allergy to acetaminophen
  • Liver disease (chronic or active)
  • Chronic alcohol use (>1 drink/day)
  • Bleeding diathesis
  • Renal disease
  • Opiate dependent or daily use
  • History of chronic pain
  • Mental or cognitive disorder preventing patient to accurately verbalize pain levels
  • Undergoing abdominal or laparoscopic procedures at the time of surgery
  • Allergy to hydromorphone
  • Surgery is not performed under general anesthesia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IV AcetaminophenIV AcetaminophenSubjects will receive a 1000mg dose of IV acetaminophen in 100mL solution every 6 hours for 24 hours. The first dose will be administered prior to anesthesia induction, approximately 30 minutes before skin incision. A total of 4 doses will be given.
SalineIV AcetaminophenSubjects will receive a 100mL dose of IV saline every 6 hours for 24 hours. The first dose will be administered prior to anesthesia induction, approximately 30 minutes before skin incision. A total of 4 doses will be given.
Primary Outcome Measures
NameTimeMethod
Total Amount of Narcotic Consumption in the First 24 Hours Post Surgery24 hours

Hydromorphone will be administered for breakthrough pain. The total amount consumed in the first 24 hours post surgery will be recorded.

Pain While Active - 18 hr18 hours

Post operative pain will be assessed 18 hours after surgery. Pain will be self reported by patients using a 0-100 mm visual analog scale (VAS) with 0 indicating no pain and 100 indicating the worst pain imaginable. A pain score will be collected for pain while active.

Secondary Outcome Measures
NameTimeMethod
Narcotic Associated Side Effects24 hours

The incidence of known narcotic associated side effects will be recorded for urinary retention.

Time to First Rescue Narcotic24 hours

The time from the end of surgery to the time any IV narcotic is given.

Time to Ambulation1800 minutes

Length of time from the end of surgery to the time of ambulation.

Trial Locations

Locations (1)

TriHealth - Good Samaritan and Bethesda North Hospitals

🇺🇸

Cincinnati, Ohio, United States

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