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Nausea in Patients Receiving Hydromorphone vs Oxycodone After Total Hip Replacement Surgery

Phase 4
Completed
Conditions
Nausea
Interventions
Registration Number
NCT02295124
Lead Sponsor
University Health Network, Toronto
Brief Summary

The study aims to compare the incidence of side effects caused by Oxycodone and Hydromorphone.

Detailed Description

Nausea and vomiting in the post-operative period is considered strongly undesirable by patients and has adverse effects on recovery from outpatient procedures, contributing significantly to delays in discharge from recovery. A know major contributor to the occurrence of post-operative nausea and vomiting is the use of opiate medications which are the cornerstone of post-operative pain management. The investigators hypothesize that the occurrence of this side-effect is different between patients prescribed oxycodone and those receiving hydromorphone for acute pain management after total hip replacement surgery. This investigation is a randomized, double-blind, head-to-head comparison to equipotent administration of oxycodone vs. hydromorphone to determine whether such a difference exists.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • American Society of Anesthesiologists Physical Status Classification System 1-3
  • Age 18-85 years
  • Patients undergoing hip replacement surgery under spinal anesthesia
Exclusion Criteria
  • patient refusal
  • contraindication or refusal of spinal anesthesia
  • inability to provide informed consent
  • history of dementia
  • intolerance or allergy to oxycodone or hydromorphone
  • chronic opioid use or chronic pain disorder
  • pregnancy
  • history of drug addiction
  • history of major psychiatric illness

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HydromorphoneHydromorphonePatients will be prescribed hydromorphone 2mg (1mg if \> age 65) every 2 hours as needed in addition to tylenol 1000mg every 6 hours and celecoxib 200mg every 12 hours.
OxycodoneOxycodonePatients will be prescribed oxycodone 10mg (5mg if \> age 65) every 2 hours as needed for post-operative pain management in addition to tylenol 1000mg every 6 hours and celecoxib 200mg every 12 hours.
Primary Outcome Measures
NameTimeMethod
The occurrence of postoperative nauseaParticipants will be followed for the duration of hospital stay, an expected average of 72 hours

The incidence and severity of nausea will be recorded twice daily up to 72 hours post-operatively

Secondary Outcome Measures
NameTimeMethod
Incidence of opioid related itching72 hours after surgery

The presence or absence of the opioid related side effects will be recorded twice daily until 72 hours post-operatively

Incidence of delirium72 hours after surgery

The presence of delirium will be recorded until 72 hours post-operatively

Daily pain scores72 hours after surgery

Pain scores (0-10) will be recorded twice daily until 72 hours post-operatively

Cumulative in-hospital opioid consumption72 hours after surgery

Total in-hospital opioid consumption in morphine equivalent doses will be calculated for the first 72 hours post-operatively

Use of anti-nausea medications72 hours after surgery

The number of administrations and doses of anti-nausea medications will be evaluated until 72 hours post-operatively

Cumulative drug costs per patient72 hours after surgery

The cumulative drug cost based on all anti-nausea and analgesic medications administered will be calculated for the first 72 hours post-operatively

Post-operative admission durationTotal admission duration, an expected average of 72 hours

The number of post-operative days required for admission will be assessed. Duration is to be an expected average of 72 hours

Trial Locations

Locations (1)

Toronto Western Hospital

🇨🇦

Toronto, Ontario, Canada

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