Does a Non-Opioid Multimodal Pain (NOMO) Protocol Decrease Narcotic Use
- Conditions
- Opioid Use
- Interventions
- Drug: NOMO Protocol
- Registration Number
- NCT05386069
- Lead Sponsor
- Prisma Health-Upstate
- Brief Summary
The objective of this study is to evaluate narcotic use after implementation of a Non-Opioid Multimodal Pain (NOMO) protocol in patients who are undergoing a urogynecologic procedure. The study will also evaluate secondary outcomes, including: post-operative pain rating, length of hospital stay, postoperative antiemetic use, bladder catheterization at discharge, number of post-operative phone calls, and rate of reported side effects of opioid use (nausea/constipation). Study participants will be asked to utilize the validated Brief Pain Inventory (appendix A) scale to assess post-operative pain levels. Based on inpatient post-operative opioid use and number of opioid pills prescribed at discharge, an attempt will be made to develop an algorithm for recommended opioid prescribing patterns.
- Detailed Description
The objective of this study is to evaluate narcotic use after implementation of a Non-Opioid Multimodal Pain (NOMO) protocol in patients who are undergoing a urogynecologic procedure. NOMO protocols seek to reduce the opioid usage for patients in the postoperative period. Patients will receive multiple pain medications (usually referred to as a "pain cocktail") that work on various pain receptors throughout the body. These medications are approved for pain control; but they have few side effects and less addictive properties. The study will also evaluate secondary outcomes, including: post-operative pain rating, length of hospital stay, postoperative antiemetic use, bladder catheterization at discharge, number of post-operative phone calls, and rate of reported side effects of opioid use (nausea/constipation). Study participants will be asked to utilize the validated Brief Pain Inventory (appendix A) scale to assess post-operative pain levels. Based on inpatient post-operative opioid use and number of opioid pills prescribed at discharge, an attempt will be made to develop an algorithm for recommended opioid prescribing patterns.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 11
- English-speaking females
- greater than or equal to 18 years old
- scheduled for a urogynecologic procedure at GHS requiring inpatient stay or extended observation.
- less than 18 years of age
- non-English speaking patients
- unscheduled urogynecologic surgeries
- patients expected to undergo a simple reconstructive surgery with same-day discharge,
- history of chronic pain
- chronic Lyrica or Celebrex use
- psychiatric disorder, narcotic dependence or narcotic prescription in the past six weeks
- current liver disease
- kidney disease (defined as GFR <60)
- malignancy
- sulfa allergy
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Treatment Arm NOMO Protocol Patients to receive standard weight-based ketamine bolus (0.5 mg/kg) at start of procedure, withhold opioids in post-operative period unless rescue medications fail
- Primary Outcome Measures
Name Time Method Morphine Milligram Equivalents used during inpatient stay from immediately postoperative through discharge or 4 weeks, whichever comes first Opioid usage will change during the postoperative period
- Secondary Outcome Measures
Name Time Method Patient satisfaction score postoperative day 2 and postoperative day 7 Evaluated via the "Brief Pain Inventory (Short Form)"; rate pain on scale 0-10, 10 being worst
Passage of Voiding Trial from immediately postoperative through discharge or 4 weeks, whichever comes first percentage of patients who pass voiding trial on POD#1
Prescription for Opioid at Discharge postoperative day 2 through postoperative day 7 Did the patient require a narcotic prescription
Length of Hospital Stay postoperative day 1 through discharge or 4 weeks, whichever comes first How many days was the patient inpatient
Anti-emetic use from immediately postoperative through discharge or 4 weeks, whichever comes first Did the patient require anti-emetics in the post-operative period
Trial Locations
- Locations (1)
Prisma Health - Upstate
🇺🇸Greenville, South Carolina, United States