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Post-Op Pain Control for Prophylactic Intramedullary Nailing.
Sponsor: St. Louis University
Summary
Nationally, the opioid crisis has become a major epidemic with increasing mortality rates each year. Orthopedic surgeons routinely prescribe narcotics instead of NSAIDs for post-op pain control because of risk of delayed healing and nonunion due to NSAID use. Orthopedic oncology, however, has a unique subset of patients that undergo prophylactic placement of intramedullary femoral nails. Because no fracture is present, these patients do not rely on inflammatory healing factors, allowing for post-op NSAID use. This study sets out to determine the effect of post-op toradol use in addition to opioids compared to solely opioids in patients undergoing prophylactic nailing of the femur.
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
60
Start Date
2019-02-20
Completion Date
2026-12-31
Last Updated
2025-10-15
Healthy Volunteers
No
Interventions
Ketorolac
IV Ketorolac to be given over the course of the first 24 hours after surgery. See arm/group description for further details.
Normal saline
An IV normal saline placebo prepared by the hospital pharmacy.
Acetaminophen
acetaminophen 500 mg PO Q4 hours PRN for mild pain
Oxycodone Acetaminophen
oxycodone-acetaminophen 5-325 mg PO Q4 hours PRN for moderate to severe pain
Morphine
morphine IV PRN (or other opioid) for severe breakthrough pain
Hydrocodone/Acetaminophen
At discharge, patients will be prescribed 1-2 hydrocodone-acetaminophen 5-325 mg Q4 hours. Those with preexisting liver disease will be prescribed the equivalent in oxycodone.
Oxycodone
Upon discharge, patients will be prescribed the equivalent of 1-2 hydrocodone 5mg Q4 hours upon should they have preexisting liver disease and are unable to consume acetaminophen.
Locations (1)
Saint Louis University
St Louis, Missouri, United States