BPH With Urinary Obstruction, BPH With Urinary Obstruction With Other Lower Urinary Tract Symptoms, Pain
Conditions
Keywords
postoperative pain, Transurethral resection of the prostate, Multimodal pain control
Brief summary
The purpose of this study is to develop a multi-modal protocol for pain management after TURP that minimizes opioid use. The investigators hypothesize this approach will provide non-inferior pain control to the current standard of care which includes opioids as the primary agent. The investigators believe this is an important step in reducing the opioid epidemic in surgical patients.
Detailed description
In our study, the investigators will randomize TURP patients to standard of care versus a multi-modal protocol. Multi-modal pain control is defined as: analgesia that combines 2 or more agents that act by different mechanisms to provide analgesia with better pain relief and less opioids. In addition, patients in the intervention arm will receive education regarding pain control and opioid use. The investigators aim to demonstrate non-inferior pain control with this approach. The investigators hope this will inform new guidelines for pain control after TURP, minimize opioid use in this patient population, and educate physicians and patients on providing excellent pain control while minimizing the risks of opioid use. The investigators believe this could ultimately serve as a model for other endoscopic urologic procedures as well.
Interventions
DRUGIbuprofen 600 mg
We'll be adding ibuprofen while trying to limit oxycodone use while hospitalized. Patients will not be discharged with a narcotic.
BEHAVIORALEducation
We'll be adding education to patient's post-operative instructions to aid in their pain control management.
Sponsors
Virginia Mason Hospital/Medical Center
Benaroya Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Are identified as candidates for TURP * Are 18 years of age or greater * Are proficient in English
Exclusion criteria
* Have filled an opioid prescription in the last 2 months * Have an allergy to a medication included in the protocol * Have a history of pelvic radiation * Have renal failure (Serum Cr \> 2.0 mg/dl), peptic ulcer disease, history of gastric bypass, cirrhosis, or other contraindication precluding use of NSAID's * Have liver failure, hepatitis, or alcohol abuse which precludes use of acetaminophen
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Opioid Consumption | PACU-72 hours | Total opioid utilization |
| Pain Scores | PACU-72 hours | Numerical Rating Scale Pain Scores (Range: 0-10, where 0 is no pain and 10 is the worst pain) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Presence of a foley catheter at discharge. | 0-48hours | Was the patient discharged with a Foley catheter? |
| Presence of narcotic side effects | 48 hours after discharge | nausea/vomiting, pruritus, constipation, dizziness or feelings of sedation |
| Were there any post-operative complications | 0-48 hours | Any complications post-operatively that occurred in the immediate post-operative setting. |
Countries
United States
Contacts
Primary ContactRyan Donahue, MD
Outcome results
None listed