Viewing Study NCT04171050



Ignite Creation Date: 2024-05-06 @ 1:59 PM
Last Modification Date: 2024-10-26 @ 1:22 PM
Study NCT ID: NCT04171050
Status: COMPLETED
Last Update Posted: 2023-05-16
First Post: 2019-11-15

Brief Title: Pudendal Enhancement of Enhanced Recovery After Surgery ERAS for Reconstructive Surgery PEERS
Sponsor: University of California Los Angeles
Organization: University of California Los Angeles

Study Overview

Official Title: Pudendal Enhancement of Enhanced Recovery After Surgery ERAS for Reconstructive Surgery PEERS
Status: COMPLETED
Status Verified Date: 2024-07
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: False
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: None
Brief Summary: Patients will undergo their vaginal reconstructive surgery in the usual manner but will also be randomly assigned on the day of surgery to either receive the extra injection of numbing medication at the onset of surgery or not The chances they will be assigned to the additional injection is 50 Their care in the hospital and after surgery will be the same They will participate in the study for a total of 6 weeks during which time they will be asked to complete two phone surveys during which a provider will check in on pain level and pain medication use and one office visit at 6 weeks The office visit is part of their routine care and would be a scheduled visit regardless if they participated in the study or not If they are unable to return to the office for a postoperative visit at 6 weeks they will be contact by phone instead to obtain information on satisfaction with postoperative care any complications after surgery and overall how they are doing after surgery
Detailed Description: PROTOCOL SUMMARY ANDOR SCHEMA

To determine whether administration of a PNB at time of vaginal reconstructive surgery can reduce use of narcotics and reported pain scores in the immediate postoperative period within the setting of multimodal postoperative pain control of ERAS Women 18yo undergoing vaginal reconstructive surgery without a hysterectomy will be randomized to either standard of care with typical use of local anesthetic during their surgery versus perioperative PNB in addition to typical use of local anesthetic during their surgery PNB will be performed with 05 bupivacaine and 10cc will be injected bilaterally All patients will be on a standard preoperative and postoperative multimodal pain regimen Patients will be followed until 6 weeks after surgery

OVERVIEW OF STUDY DESIGNINTERVENTION

This will be a prospective blinded randomized controlled trial We will recruit women who are undergoing vaginal prolapse repair surgery with a Female Pelvic Medicine and Reconstructive Surgery fellowship-trained provider within the UCLA Health System Women will be recruited prior to undergoing vaginal reconstructive surgery They will then be randomized to control group with standard of care with local anesthesia used during surgery Group 1 or PNB in addition to use of local anesthesia typically used during surgery Group 2

All pain medication will be standardized Preoperative medications per our ERAS protocol will include oral acetaminophen 1000mg gabapentin 600mg and celecoxib 400mg During surgery the patient will undergo their randomized intervention as either Group 1 or Group 2 Postoperative medications per our ERAS protocol including scheduled acetaminophen 1000mg PO every 6 hours and ketorolac 30mg IV every 6 hours For supplemental pain medication patients will have the following available tramadol 50mg PO every 6 hours as needed for moderate pain pain 4-610 on NRS scale tramadol 100mg PO every 6 hours as needed for severe pain pain 7-1010 on NRS scale and oxycodone 5mg PO every 4 hours as needed for breakthrough pain as supplemental pain medication If the above regimen does not allow for sufficient pain control then additional hydromorphone IV 02mg or morphine IV 2mg can be ordered by the provider as needed but will not be standard in the postoperative order set The providers will know what intervention the patients underwent but the patients and the care team obtaining pain scores in the hospital will be blinded to the intervention

The patients pain scores on the numeric rating scale NRS and supplemental opioid use measured in morphine milligram equivalent MME will be tracked during their hospitalization which is typically a 23-hour observation They will then be called at 48 hours for further follow-up on pain score by NRS and asked how much opioid medication they have taken since leaving the hospital and their overall satisfaction with their pain control To help with the determination of supplemental pain medication used and pain scores the patients will be provided a worksheet upon discharge that outlines their recommended medication routine allows them to record their supplemental opioid medication use with dose and time and also provides space for them to record their pain score at 48 hours post operatively The patient will then be contacted at 2 weeks after surgery to determine if they have returned to normal activities walking sitting and performing daily household tasks comfortably and if so at what point this occurred as well as their overall satisfaction with their postoperative pain control again The two week contact will be either a phone call or clinic visit depending on the providers preference for patient follow-up The last point of contact will be at 6 weeks to determine time to return to normal activities if they had not met this milestone at the 2-week contact and again assess their overall satisfaction with their postoperative pain control If a patient is discharge same day instead of admitted for 23-hour observation they will also receive a call at 24 hours postoperative to check on pain score and supplemental pain medication used

Study Oversight

Has Oversight DMC: None
Is a FDA Regulated Drug?: True
Is a FDA Regulated Device?: False
Is an Unapproved Device?: None
Is a PPSD?: None
Is a US Export?: None
Is an FDA AA801 Violation?: None